Hip Pelvis.  2014 Mar;26(1):45-49. 10.5371/hp.2014.26.1.45.

Dyspareunia Caused by Pelvis Malunion

• Lee SW
• Choi KC
• Kim MS
• Kim WY

• KMID: 2054162
• DOI: http://doi.org/10.5371/hp.2014.26.1.45

Abstract

In unstable pelvic ring injury, if there is damage to both the anterior and posterior, both anterior and posterior fixation will be needed in order to stabilze the pelvic ring. A female patient complained of dyspareunia due to malunion and additional bone bridge at the inferior ramus of the pelvis. She should have undergone both anterior and posterior fixation, but had undergone anterior fixation only. We report on a patient who was treated successfully with resection of additional bone bridge, scar tissue and adhesive band around the vagina.

Keyword

Pelvic ring injury; Pelvis fracture; Sexual dysfunction

MeSH Terms

Adhesives
Cicatrix
Dyspareunia*
Female
Humans
Pelvis*
Vagina
Adhesives

Figure

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  Fig. 1 (A) Initial pelvis anteroposterior radiograph, (B) comuputerized tomography image, (C) and 3-dimensional reconstructed image show both rami fracture and right sacro-iliac joint disruption (Tile type C [AO/OTA type C]).

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  Fig. 2 On the situation of extensive soft tissue damage around sacrum, despite Tile type C (AO/OTA type C), posterior stabilization did not be performed, but the reduction and anterior stabilization were achieved by external fixator.

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  Fig. 3 (A) After 6 years of operation. Plain radiograph, (B) coronal image, (C) and axial image of computed tomography scan (D) show the superior migration of right ilium and the formation of bony bridge at left inferior ramus. Consequently, vaginal wall compressed by the protruded bony bridge is seen in axial image of T2 weighted magnetic resonance imaging.

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  Fig. 4 (A) Gross photo shows the incision line for inguinal approach. (B) The protruded bony bridge was exposed through inguinal approach. (C) Excised fragments which were consisted of the bony bridge. (D) The excision of constricting band formed by scar tissue was performed using trans-vaginal approach.

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  Fig. 5 Plain radiograph (A) and 3-dimensional computed tomography image (B) show the finding that the protruded bony bridge was excised. R: right, L: left, H: head, F: feet

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