Progress of Traditional Chinese Medicine Nursing Technology in Rectus Abdominis Diastasis

Rectus abdominis diastasis is a common condition in postpartum women,causing back pain,and in severe cases,it can result in abdominal wall hernias and downward migration of abdominal organs.At present,there is no clearly established optimal non-surgical treatment for rectus abdominis diastasis,but traditional Chinese medicine(TCM)nursing techniques have proven to be an effective intervention for postpartum rectus abdominis separation.This paper comprehensively analyzes the TCM nursing technology as an intervention for postpartum rectus abdominis separation,discusses the shortcomings and prospects of TCM nursing technology,and provides references for further exploring and optimizing the intervention program for postpartum rectus abdominis separation.

Postpartum pubic symphysis diastasis-conservative and surgical treatment methods, incidence of complications: Two case reports and a review of the literature

BACKGROUND Widening of the pubic joint of more than 10 mm is diagnostic and defined as pubic symphysis diastasis and is considered a complication of vaginal childbirth or pregnancy.As it is a rare pathology(ranging from 1 in 300 to 1 in 30000 pregnancies),no gold standard treatment has been defined.CASE SUMMARY This study examines two cases,a 27-year-old woman(gravida 1,para 1)and a 32-year-old woman(gravida 2,para 2),who presented to the clinic after uneventful vaginal deliveries.A normal pregnancy with no complications was observed in both patients.Severe pain in the pubic region occurred after labour and was accompanied by complicated locomotion.Pubic symphysis diastasis was confirmed radiologically and bed rest with lateral decubitus positioning was recommended.Oral non-steroidal antiinflammatory drugs were administered to relieve pain exacerbations.The symptoms decreased after treatment.Posttreatment magnetic resonance imaging(MRI)in the first case showed a reduction in symphyseal separation with no signs of osteitis.Three years later the symptoms recurred;MRI examination showed no further symphyseal widening or signs of osteitis.A relapse of symphyseal separation was diagnosed and conservative treatment was re-administered resulting in successful recovery.In the second case,pain recurred when the patient conceived for the second time.This time no benefit following conservative treatment was observed.Persistent pain and complicated locomotion led to scoliotic deformation of the lumbar part of the spine and leg length discrepancy,thus surgical treatment was chosen and internal pubic synthesis was performed.CONCLUSION Overall,surgical treatment resulting from insufficient conservative treatment showed a high risk of postoperative complications following the treatment of postpartum pubic symphysis diastasis.

Pelvic Reconstruction after Chronic Pubic Symphysis Diastasis and Bladder Herniation

The research proposes a surgical technique for patients with chronic pubic symphysis diastasis and bladder herniation by means of a pelvic reconstruction technique. Three patients were treated initially in other hospitals and referred to us. All presented with pubic symphysis diastasis greater than 7 cm and bladder herniation. Two patients were initially treated with external fixation, and in one patient, the symphysis diastasis had been completely neglected. All cases presented good evolution with the proposed technique, which is described in details in the paper.

Severe Pubic Symphysis Diastasis Managed Conservatively: A Case Report and Review

Background: Pubic symphysis diastasis (PSD) is an uncommon complication of labor and delivery. Common risk factors of PSD include precipitous labor, rapid second stage of labor, intense uterine contractions, prior pelvic pathology, multiparity and macrosomia. Diagnosis is made clinically and confirmed by imaging. Management of PSD depends on the severity of symptoms and degree of symphysis separation. Standard therapy is conservative, but surgery may be needed in severe cases. Case Report: A 25-year-old female at term pregnancy presented in active labor and had a rapid second stage of labor without intravenous oxytocin or an epidural. She was subsequently diagnosed with severe PSD with a 5.5 cm separation. Her management included a pelvic binder, pain management, physical therapy, and serial imaging to monitor improvement. Discussion: In severe cases, surgery can be avoided in favor of conservative measures for the management of PSD. Multidisciplinary involvement with orthopedic surgery, radiology, physical therapy, and anesthesiology can play a vital role in optimal management. PSD may recur in future deliveries, but this does not preclude vaginal birth.

Symphyseal Disjunction after Dystocic Vaginal Delivery: About Two Cases at the SourôSanou University Hospital of Bobo-Dioulasso (CHUSS)

Diastasis of the symphysis pubis is a rare postpartum complication. We report two cases of symphysis diastasis after dystocic delivery, in two patients who presented in the postpartum period with functional impotence, pubalgia and acute urine retention. A frontal radiograph of the pelvis confirmed the diagnosis, showing a symphyseal separation of 12 mm and 18 mm. In our case, management was mainly medical, with a favorable clinical outcome.

Non-anatomic fixation for longstanding traumatic pubic diastasis using a bone graft： A report of two cases

The incidence of internal fixation failure of symphysis diastasis varies from 6% to 75%. Hardware breakage or migration and symphysis disruption recurrence are often asymptomatic and only in a few cases reoperation is required. This report describes the managements of two cases after failed internal fixation and neglected traumatic symphysis diastasis when it was technically impossible to achieve anatomical reduction of the anterior pelvic ring. Internal fixation and a bone graft for the symphysis without anatomical reposition were performed. Both of the patients achieved good results and had no complaints of pain during daily activities. Restoration of the anatomy should not be the aim in treating recurrence of the symphysis diastasis after failed fixation. The aim of the surgery was static fixation of the anterior pelvic ring with bone grafting.

Spontaneous urinary voiding of metallic screws in a patient with symphyseal plating for type II pelvic ring disruption

With rapid advancement in surgical techniques and improvement in implant materials, rate of internal fixation for pubic symphyseal disruption in rotationally and vertically unstable pelvic ring injuries has increased. Among various modes of implant failure, screw/ plate breakage and loosening are common complications following unstable fixation. Migration of loose screws into the urinary bladder has been reported as an extremely uncommon complication of pubic symphyseal plating. Here we present a case report of a 52-year-old female who pre- sented with asymptomatic passage of screws in her urine following migration into the bladder, 2 years after symphy- seal plating for pubic diastasis in an anteroposterior compression pelvic ring injury.