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Stress fractures of the pubic ramus. A report of twelve cases

The Journal of Bone & Joint Surgery.  1982; 64:1020-1025 
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Abstract

Twelve stress fractures of the pubic arch were seen in eleven patients who were joggers, long-distance runners, or marathoners. In two of the fractures there were complications of healing; that is, delayed union or refracture. With two exceptions, the lesions occurred in women between the ages of nineteen and forty-eight. In all of the patients the fracture was in the inferior pubic ramus near the symphysis pubis, and caused pain in the groin, buttock, or thigh. All fractures were non-displaced and easy to overlook on the initial radiographic examination; when a fracture of the pubic arch was clinically suspected but the radiographs were normal, a radionuclide bone scan was diagnostic. After identification of the fracture, running had to be curtailed until the symptoms disappeared in order for healing to occur.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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