The pubic bone forms the anterior as well as the ventral part of the pelvis and hence covers almost half of it. This pubic bone has a layering of fat covered by mons pubis. Pubic is divided into body, superior ramus and inferior ramus. Both the ramus forms an integral part of the pubic bone and is also very vulnerable to accidental injuries and fractures. Pubic rami forms the major part in the pelvis front.
The pubic rami comprising of both superior and inferior ramus is thin and flattened portion of ischium that is the lowermost portion of coxal bone. This coxal bone rises form body’s lower areas and connects with the inferior pubic rami and this meeting point is indicated in a grown up adult by the presence of elevated line. The superior and inferior pubic rami together are also called as ischiopubic ramus. This ischium forms the inferior posterior pelvis compartment and the bony projections from the ischial tuberosity at the posterior end. They are placed on either side of the inner pelvis and aids in maintaining balance while in sitting position. Both the pubic rami together form a big opening termed as obturator foramen along with the other part of the pubis which acts as the passage for key blood vessels and nerves that go along and reach legs as well as feet.
The inferior pubic ramus moves laterally downwards starting from the medial wrap inside the superior ramus and has a thin flattened structure. As it goes below it becomes narrower and joins the obturator foramen.
The superior pubic ramus is the major part of pubic bone and also an essential portion of obturator foramen. It is divided into two parts: a medial flattened part and a narrow lateral prismoid portion. This medial portion belonging to superior ramus was earlier thought to be the body of pubis. It has quadrilateral like shape and demonstrates two surfaces and borders on three sides. The anterior surface of superior pubic ramus is rough and moves outward and downward and acts as the origin point for different muscles.
Since the pubic rami are placed in the front of pelvis, whenever the pelvis gets damaged, it’s the pubic rami that actually gets damaged or fractured first. Such fractures are more common in old people due to fall or accident on vehicle. The symptoms of pubic rami fracture include pain in groin, pain in leg making walking difficult. The diagnosis is done with the help of X-rays and in some cases MRI’s can also be recommended for the diagnosis.
More often than not the fractures of pubic rami are allowed to heal without any type of surgery as they do not pose any chances of permanent disability. Medications like analgesics and non-steroidal anti inflammatory pills are prescribed to relieve the pain. Since pubic rami are a very small structure involved in the process of walking, the patient usually starts walking in couple of days properly and by the end of month should feel normal.