Durerea pelvina la femei in timpul ultimului trimestru de sarcina, dupa nastere ramane problema urgenta in obstetrica, traumatologie. Scopul: Imbunatatirea rezultatelor tratamentului simfiziolizei postpartum. Material si metode: Realizat studiu prospectiv, 24 paciente cu simfizioliza postpartum, cu diastaza oaselor pubiene, instabilitatea pelvina, divizate in 2 grupe conform tratamentului chirurgical. La radiografie 18 paciente cu diastaza 14-18 mm, la 6 paciente 34-58 mm, cu afectarea articulatiei iliosacrale, deplasarea verticala a oaselor pelvine. Opt paciente tratate conservativ - repozitionare inchisa conform metodei Revenko, orteza, bandaj strans. Pacientele (n=16) operate - repozitionare inchisa si fixare stabila cu dispozitiv extern. Studiul realizat in cadrul proiectului AgentieiNCercetareD nr. 20.80009.8007.11. Rezultate: Evolutiv in I grupa s-au constatat acuze - disconfort, durere reziduala, tulburari dizurice. Din complicatii: pneumonie (n=1), cistita (n=3). Pacientele (n=2) cu durere constanta timp de trei ani, supuse tratamentului chirurgical - artrodeza simfizei. La pacientele din grupul II (n=16) efectuata osteosinteza minim invaziva a inelului pelvin cu eliminarea simultana a deplasarii longitudinal (n=16), vertical (n=5) a oaselor pelvine cu dispozitiv de fixare externa. Spitalizare pentru cel mult 6 ore. Peste 9 zile s-au miscat liber, ingrijindu-se singure copii, timpul de fixare 46?1,2 zile, tratamentul cu rezultate bune. Nastere naturala repetata la 2 femei din acest grup. Concluzie: Tratamentul conservativ al leziunilor articulatiilor inelului pelvin in timpul nasterii este ineficient, iar utilizarea fixarii externe minim invazive cu o restaurare a integritatii inelului pelvin asigura reabilitarea femeilor intr-un timp scurt. Gravidele din grupul de risc pentru simfizioliza necesita identificare si monitorizare pana la recuperare completa.

Pelvic pain in women during the last trimester of pregnancy, after childbirth remains an urgent problem in obstetrics, traumatology. Aim: To improve the treatment outcomes of postpartum symphysiolysis. Material and methods: Study of 24 patients with postpartum symphysiolysis, with diastasis of the pubic bones, pelvic instability, divided into 2groups. On radiography, 18 patients with diastasis 14-18 mm, 6 patients 34-58 mm, with damage to the ilio-sacral joint, vertical displacement of the pelvic bones. Conservative treatment in 8 patients: closed repositioning the Revenko method, orthosis. In 16: closed repositioning with external device. Study carried out within the project of AgencyNCercetareD no.20.80009.8007.11. Results: In the 1st group - discomfort, residual pain, dysuric disorders. Complications – pneumonia (n=1), cystitis (n=3). Patients (n=2) with pain for 3years, subjected to surgical treatment - symphysis arthrodesis. In group II patients (n=16), minimally invasive osteosynthesis of the pelvic ring was performed with the simultaneous elimination of the longitudinal(n=16), vertical(n=5) movement of the pelvic bones with an external fixation device. Hospitalization <6 hours. After 9 days they moved freely, taking care of the children by themselves, the fixation time 46?1,2days, the rate with good results. Repeated natural birth in 2 women from this group. Conclusion: Conservative treatment of injuries of the pelvic ring joints during childbirth is ineffective, and the use of minimally invasive external fixation with a restoration of the integrity of the pelvic ring ensures the rehabilitation of women in a short time. Pregnant women in the risk group for symphysiolysis require identification and monitoring until full recovery.