RT Journal
A1 Kotwal, P. P.
A1 Mittal, Ravi
A1 Kowalk, David L.
A1 Perdue, Philip S.
A1 Bourgeois, F. John
A1 Whitehill, Richard
T1 Correspondence
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 1998
FD March 1
VO 80
IS 3
SP 452
OP 452
DO 
UL http://dx.doi.org/
AB 
    We read with interest "Disruption of the Symphysis Pubis during Vaginal Delivery. A Case Report" (78-A: 1746—1748, Nov. 1996), by Kowalk et al. However, we disagree with some points. First, this is not the second case of its type as Kowalk et al. stated. Numerous cases of similar injuries have been reported2-6. Second, contrary to their claim, we found that the same ligaments are damaged in obstetric and traumatic disruptions of the symphysis pubis, with the posterior sacroiliac ligament remaining intact3,8. The method of treatment, therefore, should be the same for both types of injury. Third, Kowalk et al. claimed that the spontaneous tightening of ligaments in the postpartum period contributes to the stability of the pelvis and that the patient can be mobilized as early as the second day after delivery. We believe that the pelvis should be stabilized and gait-training should be postponed for six weeks after the traumatic type of disruption8 and until the patient becomes comfortable after the obstetric type of disruption4,6.