Pubic bone: anatomy, function and treatment

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The pubic bone, also known as the pubic bone, is located in front of the pelvic girdle. Behind, the ilium and ischium form a bowl-shaped pelvic girdle. The two halves of the pubic bone are joined in the middle by an area of cartilage called the pubic symphysis. The largest bones are highest at the back of the pelvic girdle. These bones are almost directly above the femur and are often seen in women and people with a little fat. The pubic bone is not visible from the outside of the body and joins the anterior half of the pelvic girdle.

Anatomy

The pubis is in front of the body, just below the abdomen. This area provides structure and protection to the genitourinary organs in both sexes, including the bladder, uterus, ovaries, prostate, and testicles.

Most of the pubis is called the pubic body, which is located at the highest point of the pubis. The back of the pubis connects to the ilium , one of the bones at the back of the pelvic girdle. The ischio-pubic branch is the area where the ischium and pubic bone meet. This posterior part also contains the pubic tubercle, which is a small tubercle to which muscles and ligaments attach.

The area of the pubis where the pubic bone meets the ilium is an angle called the superior pubic ramus. Between the upper branch of the pubic bone and the upper part of the pubis is the thoracic line, which is another area where muscles and ligaments are inserted for stabilization. Directly in front of the upper pubic ramus is the lower ramus, which points downward toward the lateral part of the pubic bone.

The pubic bone then curves downward and turns into cartilage in the middle. This arched region of the bone is called the pubic arch, which also connects to the pubic symphysis where the two ends of the pubic bone meet.

Rasi Bhadramani / Getty Images

Anatomical variations

One of the most important anatomical changes in the pubic bone is the difference in the size of the pelvis. This means that the distance between the pubic symphysis and the insertion point of the thigh can vary, as can the angles of the pubic arch, the length of the pubic symphysis, and the radius of the socket the thigh enters. There are also variations in the pubic bone depending on the ability to carry babies.

The female pelvis can be classified as gynecoid, indicating that the pelvis is well adapted for childbirth, or anthropoid, indicating a somewhat adequate structure for childbirth.

Other more common types of pelvis in men are the android and flat feet, which have angles that are not biologically designed for childbirth. A woman with a pelvis classified as platypelloid or anthropoid generally does not undergo a traditional vaginal delivery and often requires alternative methods of delivery (eg, Caesarean section ).

Function

The main function of the pubis is to protect the intestines, bladder, and internal genital organs. The pubis also connects to the hip bones and provides support close to the body, allowing downward movement of the leg.

The pubis connects to the back bones of the pelvic girdle, holding them in place and allowing the circular structure to connect the upper half of the body to the lower half of the body.

The pubic bone also has several skeletal landmarks that allow for the attachment of muscles, cartilage, ligaments, and tendons. Each of these structures supports the healthy formation of joints, bones, and body structures.

The pubic bone performs a secondary motor function, since its main function is to stabilize the pelvic girdle. The cartilaginous pubic symphysis has little movement at the loose connection of the two halves of the pubic bone. However, the main purpose of this cartilage is also stabilization. All the organs of the pelvic girdle have complex innervation, which means that several important nerves run through the pelvic girdle and its structures.

Related conditions

Like any bone, the pubic bone can fracture and must be immobilized to ensure proper and complete healing. This immobilization is often supplemented with blood tests to make sure there is no infection and X-rays to monitor the healing process.

The pubic bone can also be affected by an inflammatory condition called osteitis pubis , in which a person experiences what appears to be abdominal pain or pain in the lower groin. If not treated properly, this condition can develop into pubic osteomyelitis. Pubic osteitis is a condition that is often mistaken for simple abdominal pain, menstrual pain in women, or muscle sprains. This can happen during pregnancy . Obtaining a correct diagnosis with ultrasound and a comprehensive examination is essential for accurate treatment.

Osteomyelitis is an infection of the bones that is difficult to treat due to the likelihood and ease of spreading the infection to other bones through nearby tissues or the bloodstream. Although osteomyelitis of this bone is quite rare, this condition often leads to additional medical complications.

Pubic osteitis and osteomyelitis are treated with powerful antibiotics, which are designed to kill bacteria and clear the infection. These conditions also often cause external wounds to the skin and tissues that must be thoroughly cleaned, bandaged, and immobilized. for a complete and complete healing.

Rehabilitation

Rehabilitation of pubic bone fractures consists mainly of immobilization to repair the bone. The pubic bone is difficult to immobilize separately from the rest of the body, which means that large-scale restrictions are required to prevent any movement that may interfere with the healing process. These restrictions often include being in bed for several weeks and performing passive upper and lower extremity movements with the help of a therapist. Once the X-ray shows that healing is complete, the person begins physical rehabilitation to strengthen the muscles and prevent the injury from reoccurring.

Rehabilitation of a pubic fracture is similar to that performed after osteomyelitis or pubic osteitis. The disciplines , including physical therapy and occupational therapy, can address different treatment areas to restore function. The focus is on restoring muscle strength that may have been lost through immobilization and deterioration. This is addressed through resistance exercise programs for the upper and lower extremities, modeling and assisted self-care, balance training, gait training, and other treatments specific to individual needs.

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