49:
518:
198:
506:
494:
29:
250:. The superior pubic ligament connects together the two pubic bones superiorly, extending laterally as far as the pubic tubercles. The inferior ligament in the pubic arch is also known as the arcuate pubic ligament or subpubic ligament; it is a thick, triangular arch of ligamentous fibers, connecting together the two pubic bones below, and forming the upper boundary of the
362:
The pubic symphysis widens slightly when the legs are stretched far apart. In sports where these movements are often performed, the risk of a pubic symphysis blockage is high, in which case, after completion of the movement, the bones at the symphysis do not realign correctly and can get jammed in a
416:
remodel this ligamentous capsule allowing the pelvic bones to be more flexible for delivery. The gap of the symphysis pubis, normally is 4–5 mm but during pregnancy there will be an increase of at least 2–3 mm, therefore, it is considered that a total width of up to 9 mm between the
345:
Analysis of the pelvis shows the skinny regions function as arches, transferring the weight of the upright trunk from the sacrum to the hips. The symphysis pubis connects these two weight-bearing arches, and the ligaments that surround this pelvic region maintain the mechanical integrity.
328:
In the newborn, the symphysis pubis is 9–10 mm in width, with thick cartilaginous end-plates. By mid-adolescence the adult size is achieved. During adulthood the end-plates decrease in width to a thinner layer. Degeneration of the symphysis pubis accompanies aging and
838:
Obstetrics and
Gynaecology in The Tropics and Developing Countries. J. B. Lawson, Professor of Obstetrics and Gynaecology, University of Ibadan, Nigeria; D. B. Stewart, Professor of Obstetrics and Gynaecology, University of The West Indies,
392:, the most common inflammatory disease in this area, is treated with anti-inflammatory medication and rest. Degenerative joint disease of the symphysis, which can cause groin pain, results from instability or from abnormal pelvic mechanics.
464:
This practice was carried out in Europe before the introduction of the
Caesarean section. Historically, during obstructed labor, the skull of the fetus was also, at least occasionally, crushed in order to further facilitate the delivery.
482:, as they can be used to estimate the age of adult skeletons. Throughout life, the surfaces are worn at a fairly predictable rate. By examining the wear of the pubic symphysis, it is possible to estimate the age of the person at death.
367:
position. The resulting pain can be severe, especially when further strain is put upon the affected joint. In most cases, the joint can only be successfully reduced into its normal position by a trained medical professional.
452:
is a surgical procedure in which the cartilage of the pubic symphysis is divided to widen the pelvis allowing childbirth when there is a mechanical problem. It allows the safe delivery of the fetus where
320:
is the white, shiny gristle at the end of long bones. This cartilage has poor healing potential, and efforts to induce it to repair itself frequently end up with a similar, but poorer fibrocartilage.
223:
attached to the fibrocartilage. The fibrocartilaginous disk is reinforced by a series of ligaments. These ligaments cling to the fibrocartilaginous disk to the point that fibers intermix with it.
349:
The main motions of the symphysis pubis are superior/inferior glide and separation/compression. The functions of the joint are to absorb shock during walking and allow delivery of a baby.
219:, possibly due to the nature of the compressive forces passing through this joint, which may lead to harmful vascular disease. The ends of both pubic bones are covered by a thin layer of
309:. Perichondrium surrounds the cartilage of developing bone; it has a layer of dense, irregular connective tissue and functions in the growth and repair of cartilage.
234:, which provide the most stability; the anterior and posterior ligaments are weaker. The strong and thicker superior ligament is reinforced by the tendons of the
333:. Women have a greater thickness of this pubic disc which allows more mobility of the pelvic bones, hence providing a greater diameter of pelvic cavity during
122:
944:
517:
98:
1122:
211:
joint. The width of the pubic symphysis at the front is 3–5 mm greater than its width at the back. This joint is connected by
182:. In most adults, it can be moved roughly 2 mm and with 1 degree rotation. This increases for women at the time of childbirth.
937:
1250:
293:. The collagenous fibers are usually placed in an orderly arrangement parallel to tension on the tissue. It has a low content of
755:
Scicluna, J.K.; et al. (January 2004). "Epidural analgesia for acute symphysis pubis dysfunction in the second trimester".
1068:
254:. Above, it is blended with the interpubic fibrocartilaginous lamina; laterally, it is attached to the inferior rami of the
1295:
930:
862:
Franklin, D (January 2010). "Forensic age estimation in human skeletal remains: current concepts and future directions".
179:
1201:
239:
1432:
1196:
175:
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1142:
1001:
1300:
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996:
899:
1427:
907:
at the SUNY Downstate
Medical Center – "Major Joints of the Lower Extremity – hip and sacrum (anterior view)"
263:
117:
651:
Gamble, J.G.; Simmons, S.C. (February 1986). "The
Symphysis Pubis: Anatomic and Pathologic Considerations".
505:
1422:
1106:
916:
493:
1315:
1237:
1102:
686:
Lebel, D.E.; et al. (2010). "Symphysiolysis as an independent risk factor for cesarean delivery".
422:
1268:
1188:
1042:
910:
904:
792:"Pregnancy-related pelvic girdle pain (PPP), I: Terminology, clinical presentation, and prevalence"
400:
is separation or slipping of the symphysis. It has been estimated to occur in 0.2% of pregnancies.
81:
1404:
1399:
1117:
441:(PGP). Overall, about 45% of all pregnant women and 25% of all women postpartum suffer from PGP.
235:
1441:
1305:
534:
385:
129:
105:
93:
417:
two bones is normal for a pregnant woman. The symphysis pubis separates to some degree during
1446:
1260:
1228:
1037:
1025:
479:
426:
1273:
377:
259:
163:
34:
8:
1368:
1333:
1287:
1178:
1093:
1064:
159:
913:
at the SUNY Downstate
Medical Center – "The Male Pelvis: Hemisection of the Male Pelvis"
1376:
816:
791:
711:
628:
603:
579:
554:
438:
294:
247:
457:
is not an option. Symphysiotomy is suggested for woman in isolated areas experiencing
1170:
879:
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772:
703:
668:
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633:
619:
584:
570:
454:
364:
317:
286:
220:
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bundles have cartilage cells between them; these cells to a certain extent resemble
178:
attaches to the pubic symphysis. In females, the pubic symphysis is attached to the
1414:
1073:
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298:
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171:
86:
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768:
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Anterior view of the body pelvis from a dissection. Pubic symphysis anteriorly.
396:
389:
278:
212:
208:
807:
699:
384:
results in calcific deposits in the symphysis. Inflammatory diseases, such as
1465:
1112:
449:
306:
281:
is composed of small, chained bundles of thick, clearly defined, type I
110:
1355:
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38:
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16:
Cartilaginous joint between the front of the left and right hip bones
957:
434:
282:
205:
741:"Pubic Symphysial Diastasis During Normal Vaginal Delivery of a",
430:
413:
33:
The pubic symphysis sits between and joins of the left and right
745:
Vol. 55 No. 4 July/August 2005 pp:365-366 S. A. Panditrao et al.
1219:
267:
961:
953:
258:; below, it is free, and is separated from the fascia of the
69:
919:—Plastination Laboratory at the Medical University of Vienna
732:(2002), 13: 141-155 Kelly Owens, Anne Pearson, Gerald Mason.
437:
condition. A diastasis of the symphysis pubis is a cause of
297:(2% of dry weight). Glycosaminoglycans are long, unbranched
301:(relatively complex carbohydrates) consisting of repeating
28:
555:"The adult human pubic symphysis: a systematic review"
552:
215:
and may contain a fluid-filled cavity; the center is
553:Becker, I.; Woodley, S.J.; Stringer, M.D. (2010).
305:units. Fibrocartilage does not have a surrounding
952:
757:International Journal of Obstetric Anesthesiology
461:where other medical intervention is unavailable.
1463:
478:Pubic symphyses have importance in the field of
688:Journal of Maternal-Fetal and Neonatal Medicine
601:
473:
938:
650:
421:. In some women this separation can become a
1438:ligaments connecting the sacrum and ischium
604:"Nutrition pathways to the symphysis pubis"
429:could be the result of a rapid birth, or a
977:
945:
931:
653:Clinical Orthopaedics and Related Research
388:, result in bony fusion of the symphysis.
47:
27:
1123:Tectorial membrane of atlanto-axial joint
917:Cross section image: pelvis/pelvis-e12-15
900:Pelvic Instability Network Support (PINS)
815:
627:
578:
861:
754:
602:da Rocha, RC; Chopard, RP (March 2004).
511:Median sagittal section of female pelvis
352:
196:
1464:
499:Median sagittal section of male pelvis
468:
926:
685:
1296:intraarticular sternocostal ligament
485:
312:
185:The name comes from the Greek word
180:suspensory ligament of the clitoris
151:
13:
789:
730:Fetal and Maternal Medicine Review
170:. It is in front of and below the
14:
1488:
1202:posterior sacrococcygeal ligament
893:
273:
240:abdominal external oblique muscle
75:symphysis pubica, symphysis pubis
1433:interosseous sacroiliac ligament
1197:anterior sacrococcygeal ligament
665:10.1097/00003086-198602000-00033
620:10.1111/j.0021-8782.2004.00271.x
571:10.1111/j.1469-7580.2010.01300.x
516:
504:
492:
444:
423:diastasis of the symphysis pubis
262:by an opening through which the
176:suspensory ligament of the penis
1143:posterior atlantoaxial ligament
1002:posterior longitudinal ligament
855:
842:
412:in the human, hormones such as
1301:radiate sternocostal ligaments
1138:anterior atlantoaxial ligament
997:anterior longitudinal ligament
876:10.1016/j.legalmed.2009.09.001
850:New York Times Review of Books
832:
790:Wu, W.H.; et al. (2004).
783:
748:
735:
728:"Pubic symphysis separation".
722:
679:
644:
595:
546:
323:
189:, meaning 'growing together'.
1:
1428:posterior sacroiliac ligament
864:Legal Medicine (Tokyo, Japan)
540:
264:deep dorsal vein of the penis
1423:anterior sacroiliac ligament
1107:Transverse ligament of atlas
474:Use in forensic anthropology
403:
376:Metabolic diseases, such as
192:
7:
528:
340:
226:Two such ligaments are the
162:between the left and right
10:
1493:
1103:Cruciate ligament of atlas
769:10.1016/j.ijoa.2003.08.006
532:
380:, produce widening, while
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808:10.1007/s00586-003-0615-y
700:10.3109/14767050903420291
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204:The pubic symphysis is a
128:
116:
104:
92:
80:
68:
63:
58:
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26:
21:
1269:Costotransverse ligament
1251:Intra-articular ligament
1043:intertransverse ligament
911:Anatomy photo:44:03-0104
905:Anatomy photo:17:st-0206
1405:inferior pubic ligament
1400:superior pubic ligament
1118:Apical ligament of dens
236:rectus abdominis muscle
232:inferior pubic ligament
228:superior pubic ligament
1442:sacrotuberous ligament
1306:costoxiphoid ligaments
796:European Spine Journal
743:Journal of Obste India
535:anatomical terminology
433:delivery, or may be a
386:ankylosing spondylitis
201:
130:Anatomical terminology
53:#5 is pubic symphysis.
1447:sacrospinous ligament
1038:interspinous ligament
1026:supraspinous ligament
480:forensic anthropology
353:Clinical significance
285:fibers. This fibrous
200:
1274:Lumbocostal ligament
378:renal osteodystrophy
260:urogenital diaphragm
166:of the pubis of the
1179:iliolumbar ligament
1065:intervertebral disc
469:Society and culture
160:cartilaginous joint
1377:Obturator membrane
608:Journal of Anatomy
559:Journal of Anatomy
533:This article uses
439:pelvic girdle pain
295:glycosaminoglycans
248:muscles of the hip
202:
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852:, 22 October 2006
848:Hope Langer, MD;
486:Additional images
455:caesarean section
318:Hyaline cartilage
313:Hyaline cartilage
287:connective tissue
221:hyaline cartilage
158:) is a secondary
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1246:Radiate ligament
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1013:vertebral arches
989:vertebral bodies
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459:obstructed labor
266:passes into the
174:. In males, the
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1261:Costotransverse
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299:polysaccharides
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244:gracilis muscle
209:amphiarthrodial
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172:urinary bladder
148:pubic symphysis
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1437:
1391:
1342:no ligaments
1341:
1324:no ligaments
1323:
1288:Sternocostal
1161:no ligaments
1160:
1131:no ligaments
1130:
867:
863:
857:
849:
844:
834:
799:
795:
785:
763:(1): 50–52.
760:
756:
750:
742:
737:
729:
724:
691:
687:
681:
656:
652:
646:
611:
607:
597:
562:
558:
548:
477:
463:
448:
407:
395:
394:
375:
361:
348:
344:
327:
316:
303:disaccharide
291:tendon cells
277:
231:
227:
225:
203:
186:
184:
155:
147:
145:
99:A03.6.02.001
74:
1365:Syndesmoses
1238:Head of rib
1171:Lumbosacral
979:Syndesmosis
324:Development
256:pubic bones
206:nonsynovial
64:Identifiers
39:pubic bones
1466:Categories
1415:Sacroiliac
870:(1): 1–7.
541:References
419:childbirth
382:ochronosis
365:dislocated
335:childbirth
331:postpartum
252:pubic arch
1129:Lateral:
1057:Symphysis
970:Vertebral
958:ligaments
427:diastasis
410:pregnancy
404:Pregnancy
246:, and by
217:avascular
193:Structure
187:symphysis
168:hip bones
156:symphyses
1101:Medial:
884:19853490
826:15338362
777:15321442
716:42116716
708:20199196
638:15032910
589:20840351
529:See also
435:prenatal
341:Function
283:collagen
230:and the
839:Jamaica
817:3476662
673:3955988
629:1571274
580:3035856
431:forceps
414:relaxin
408:During
372:Disease
87:D011631
59:Details
37:of the
1477:Joints
1472:Pelvis
1356:Pelvis
1220:Thorax
954:Joints
882:
824:
814:
775:
714:
706:
671:
636:
626:
587:
577:
425:. The
358:Injury
268:pelvis
242:, the
238:, the
962:torso
712:S2CID
134:[
123:16950
70:Latin
956:and
880:PMID
822:PMID
773:PMID
704:PMID
669:PMID
634:PMID
585:PMID
146:The
111:1855
94:TA98
82:MeSH
1367:of
1011:Of
987:Of
960:of
872:doi
812:PMC
804:doi
765:doi
696:doi
661:doi
657:203
624:PMC
616:doi
612:204
575:PMC
567:doi
563:217
152:pl.
118:FMA
106:TA2
1468::
1440::
878:.
868:12
866:.
820:.
810:.
800:13
798:.
794:.
771:.
761:13
759:.
710:.
702:.
692:23
690:.
667:.
655:.
632:.
622:.
610:.
606:.
583:.
573:.
561:.
557:.
337:.
270:.
154::
1109:)
1105:(
1076:)
1067:(
946:e
939:t
932:v
886:.
874::
828:.
806::
779:.
767::
718:.
698::
675:.
663::
640:.
618::
591:.
569::
537:.
150:(
138:]
41:.
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