Table 1.
Details of anatomical studies focusing on the adult human pubic symphysis
| Author (year) | Type of study | Specimens/subjects | Anatomical data | Comment |
|---|---|---|---|---|
| Aeby (1858) | Gross | 61 cadavers 61 interpubic discs 36♂ 15–30 years (n = 12), > 30 years (n = 24) 25♀ 15–30 years (n = 12), > 30 years (n = 13) 47 interpubic clefts Sex: 25♂, 22♀ | Descriptive: articular surfaces, hyaline cartilage, interpubic disc and cleft, and ligaments Quantitative: dimensions of interpubic disc and cleft, including relationship to age and sex | Poorly described methods Anatomical reference points for measurements unclear Pregnancy-related changes described |
| Zulauf (1901) | Gross and microscopic | 107 cadavers Age: 10 days–75 years Sex: 57♂, 50♀ | Descriptive: interpubic cleft and disc Quantitative: interpubic cleft in relation to age and sex | Poorly documented methods |
| Loeschcke (1912) | Gross and microscopic | 76 cadavers 19♂ 25–75 years 19♀ 13–69 years 12 pregnant ♀ 20–39 years 26 postpartum ♀ 20–76 years | Descriptive: interpubic disc, ligaments, articular surfaces, interpubic cleft Quantitative: interpubic cleft and retropubic eminence, width of pubic symphysis related to age | Main focus on physiological changes within the pelvis during pregnancy and birth Unclear how width of pubic symphysis measured |
| Barnes (1934) | Radiographic | 27 cadavers 19♂ and ♀ adults, eight newborns 500 patients 20♂and♀ 2–14 years; 30♀ 17–23 years 140 non-pregnant ♀ 24–70 years 130♂ 25–75 years 180 pregnant ♀ (99 multipara, 81 primipara) | Quantitative: width of pubic symphysis in relation to age and sex | Anatomical reference points for width of pubic symphysis unclear No information on assessors of radiographs |
| Sutro (1936) | Microscopic and radiographic | 75 cadavers Age: 0–75 years Sex: 41♂, 34♀ (22 nullipara, 12 multipara) | Descriptive: articular surfaces, ligaments, interpubic cleft and disc, degenerative changes | Mostly descriptive with little quantitative data |
| Schmidt (1956) | Microscopic | 20 cadavers Age: 20–80 years Sex: ♂and♀ | Descriptive: distribution of collagen fibres in interpubic disc | Methods not described in detail (number of specimens sectioned in each plane uncertain) No consideration of age or sex differences |
| Vix & Ryu (1971) | Gross, microscopic and radiographic | 15 cadavers: age and sex unknown 400 adult patients: precise age unknown Sex: 200♂, 200♀ | Descriptive: articular surfaces, interpubic disc and cleft Quantitative: greatest transverse width of pubic symphysis in mid-third | Paucity of data on specimens (age, parity) No reference points for measurements given No information on assessors of radiographs |
| Putschar (1976) | Microscopic | 198 cadavers Age: 0–87 years Sex: 87♂, 111♀ | Descriptive: interpubic cleft, articular surfaces, retropubic eminence, age-related changes, degenerative changes | Summary of results from main study published 1931 Proportion of adult specimens uncertain |
| Gamble et al. (1986) | Gross, microscopic and radiographic | 20 cadavers 12 fetuses, four neonates, four adults Age and sex unknown | Descriptive: articular surfaces, shape and width of pubic symphysis, interpubic disc, ligaments, adjacent muscles, nerve and blood supply | Missing data (precise age, sex, parity) Only general descriptive results provided |
| Sgambati et al. (1996) | Radiographic | 96 patients Age: 14–89 years Sex: 64♂, 32♀ | Quantitative: anterior width of pubic symphysis at three levels (superior, middle, inferior), relationship to age and sex | Retrospective study Methods poorly described No reference points for measurements No consideration of parity in females No information on assessors of radiographs Included mean ± 2 SDs |
| Alicioglu et al. (2008) | Radiographic (CT) | 542 patients Age: 17–94 years (mean 56.7 ± 15.0 years) Sex: 264♂, 278♀ | Quantitative: width of pubic symphysis at three points (anterior, middle, posterior) through mid-section of joint, correlated to age, sex, BMI and parity | Retrospective study Width of symphysis related to gender and age No reliability data provided (one investigator, single measurements) |
| Wurdinger et al. (2002) | MR imaging | 11 healthy volunteers Age: 22–42 years, (mean 30 years) Sex: non-pregnant nulliparous♀ | Quantitative: width of pubic symphysis in coronal section, related to age | Unclear which MR images used for measuring pubic symphysis width and where measurement was taken No data on inter-rater reliability (two investigators) |
BMI, body mass index; CT, computed tomography; MR, magnetic resonance.