Function
The pubic branches have different functions in the pelvis. On the one hand they form anatomical structures together with other bones. For example, the foramen obturator is formed by the upper and lower pubic branch and the ischium (Os ischii).
Vessels and nerves run through this large opening in the pelvis. Furthermore, the pubic branches are the origin and attachment of different structures. The foramen obturatorium is closed by a membrane (Membrana obturatoria), which is attached to the two pubic branches.
Particularly noteworthy is the pubic crest (Pecten ossis pubis) on the upper pubic branch, where a muscle (Musculus pectineus) has its origin. Other muscles that are particularly responsible for pulling the thigh up (adductor muscles) also use the pubic branches as their point of origin. Another structure that represents a point of attachment is the pubic tubercle (tuberculum pubis). This is where the inguinal ligament (Ligamentum inguinale) begins.
Diseases of the pubic bone branch
A pubic branch fracture is a fracture of the pubic branch and can be divided into a complete and an incomplete pelvic ring fracture. Symptoms of a pubic ramus fracture are rather unspecific and are described as back or lower back pain that increases with movement. Such a fracture is diagnosed with the help of an x-ray or better still with a CT (computer tomograph).
Depending on the type of pelvic ring fracture, treatment varies. In an incomplete pelvic ring fracture, either the upper or the lower branch of the pubic bone is broken. In this case, the patient must remain in bed for a few days and take painkillers if necessary.
However, the patient should be mobilized again as soon as possible to avoid secondary diseases such as pneumonia. The pelvis can be stabilized by wearing a special wide belt, which many patients find comfortable. In contrast, a complete pelvic ring fracture affects both the upper and lower pubic bone.
Under certain circumstances, other parts of the pelvis may also be damaged. In this case, surgical intervention is unavoidable.Pubic inflammation (ostitis pubis, also known as pubalgia) is a non-infectious inflammation of the pubic branch or surrounding structures, such as the pubic symphysis, the entire pubic bone (os pubis) or adjacent muscles (adductors, abdominal muscles). This disease is particularly common among competitive athletes who run a lot (e.g. tennis players, footballers).
The cause of an inflammation of the pubic bone branch is a permanent overstrain. Frequently described symptoms are pain when walking and climbing stairs as well as when standing on one leg. Often the pain is localized, but can also radiate into the groin or lower abdominal muscles.
This joke sensation is intensified when the doctor performs a palpation (palpation). An inflammation of the pubic bone or branch of the pubic bone is primarily treated conservatively. The patient is prescribed anti-inflammatory drugs (antirheumatic drugs) as well as physiotherapy.
These should stretch various muscle groups and strengthen the pelvic floor muscles. A break from sports is also recommended in order to spare the inflammation site, but often meets with resistance from the patient. Pain in the pubic branch is a non-specific symptom and can have various causes.
The patient’s medical history should be taken to find out more about the symptoms. In addition, the doctor will perform a palpation examination. Nowadays, imaging procedures such as x-rays and computer tomography are often used to make a clear diagnosis.
There are many reasons for pain in the pubic bone branch and can range from a fracture to an inflammation. Fractures are more common in older patients and can be caused by a fall. Often affected persons describe this pain as a deep back pain that reaches down to the coccyx.
Inflammation in the area of the pubic bone branch is mainly found in competitive athletes who are exposed to high mechanical pelvic stress. This pain occasionally radiates into the groin or even lower abdominal muscles.
