Left superior pubic rami - L: undisplaced superior ramus # R (Torode & Zeig III) R: displaced R and L inferior and superior rami# (Torode&Zeig III) Torode & Zeig IV. Fracture near left SI joint and fracture through left superior and inferior pubic rami Torode IV injury with pubic diastasis and SI joint disruption Mature Pelvis: Lateral Compression type

 
Gross anatomy Osteology. The pubic bone has an anteromedial body, a superior ramus passing upwards to the acetabulum and an inferior ramus bordering the obturator foramen which joins the ischial ramus (conjoined ramus or the ischiopubic ramus).. The body of pubis is flattened and has an anterior, posterior, and symphyseal surface.. …. Xim cronus

In today’s digital age, where convenience and efficiency are highly valued, it’s no surprise that more and more people are turning to online platforms for their travel needs. When ... Pelvic and Acetabular Fractures. Pelvic fractures include disruption of the superior and inferior pubic rami, the acetabulum (hip socket), the iliac wing, and the sacrum. It is also possible to have a serious pelvic injury without fractured bone, as might be seen with a rupture of the ligaments that connect the two pubic rami or the ligaments ... FIGURE 1. Anterior-posterior radiograph of the pelvis, demonstrating fractures through the superior and inferior pubic rami on the left (orange arrows), as well as a fracture involving the superior ramus on the right (white arrow). These fractures were present on a radiographic examination from 2 months prior.Definition. Causes. Symptoms. Diagnosis. Treatment. Summary. A pubic ramus fracture describes a type of crack or break in a person’s pelvis. Pubic ramus fractures are not typically life...Background Pubic ramus fracture was an injury of anterior pelvic ring, the anterior pelvic ring plays an important role in maintaining the stability of the pelvis. The purpose of this study was to investigate the effect and indication of percutaneous retrograde pubic screw fixation assisted by hollow pedicle finder for pubic ramus fractures. Methods The clinical data of 68 patients with pubic ...When it comes to protecting your home and loved ones, nothing is more important than choosing the right home security system. With so many options available in the market, it can b...Pelvic and Acetabular Fractures. Pelvic fractures include disruption of the superior and inferior pubic rami, the acetabulum (hip socket), the iliac wing, and the sacrum. It is also possible to have a serious pelvic injury without fractured bone, as might be seen with a rupture of the ligaments that connect the two pubic rami or the ligaments ...Ischiopubic synchondrosis asymmetry (van Neck-Odelberg disease) is the characteristic enlargement of one of the ischiopubic synchondroses. It is largely considered an anatomic variant of skeletal development, given that it is a common and usually asymptomatic finding. However, some cases are thought to be symptomatic and may …The pubic symphysis is a midline, nonsynovial joint that connects the right and left superior pubic rami. The interposed fibrocartilaginous disk is reinforced by a series of ligaments that attach to it. The joint allows very limited movement of approximately 0.5-1mm. Under hormonal stimulation during pregnancy, there is widening of the ...Pubic rami fractures in athletes are most commonly “stress fractures” that occur due to repetitive hip movements and repetitive loads on the pelvis, like in long distance running. Stress fractures of the pubic rami are most common in these sports: • Long distance running. • Track. • Dance. • Soccer. • Football training season. • Lacrosse.Pubic ramus fracture was an injury of anterior pelvic ring, the anterior pelvic ring plays an important role in maintaining the stability of the pelvis. The purpose of this study was to investigate the effect and indication of percutaneous retrograde pubic screw fixation assisted by hollow pedicle finder for pubic ramus fractures. The clinical data of …Closed fracture left pubis; Closed fracture of left pubis; Left pubic bone fracture; ICD-10-CM S32.502A is grouped within Diagnostic Related Group(s) (MS-DRG v 41.0): 535 Fractures of hip and pelvis with mcc; 536 Fractures of hip and pelvis without mcc; 963 Other multiple significant trauma with mcc; 964 Other multiple significant trauma with ccIn this tutorial we take you through the anatomy of the pelvis using our 3D anatomy model and discuss the features and management approach of stable and unst... The pubic rami are a group of bones that make up part of the pelvis. A pubic ramus fracture is a break in one of these bones. These fractures do not need an operation and will heal with time, analgesia and therapy. They often take about 6-8 weeks to heal. You can fully weight bear as pain allows and there are no limitations to Background Pubic ramus fracture was an injury of anterior pelvic ring, the anterior pelvic ring plays an important role in maintaining the stability of the pelvis. The purpose of this study was to investigate the effect and indication of percutaneous retrograde pubic screw fixation assisted by hollow pedicle finder for pubic ramus fractures. Methods The clinical data of 68 patients with pubic ...(b) Direct X-ray of plasmacytoma, including right superior and inferior pubic ramus, expanding in the bone, causing cortical thinning and destruction in places. (c) Axial T2 sequence magnetic resonance image of a simple bone cyst in right pubic ramus. (d) X-ray of left pubic ramus insufficiency fracture.We would like to show you a description here but the site won’t allow us.The inferior pubic ramus extends downward to join the ischial ramus. Together, these form the single ischiopubic ramus , which extends from the pubic body to the ischial tuberosity. The inverted V-shape formed as the ischiopubic rami from both sides come together at the pubic symphysis is called the subpubic angle .Summary. A pelvic fracture is a break in one or more of the bones in the pelvis. This includes the sacrum, coccyx, ilium, ischium, and pubis. The type of pelvic fracture a person has may depend on ...ICD-10-CM Code for Other specified fracture of left pubis, initial encounter for closed fracture S32.592A ICD-10 code S32.592A for Other specified fracture of left pubis, initial encounter for closed fracture is a medical classification as listed by WHO under the range - Injury, poisoning and certain other consequences of external causes . A type 1 excludes note is a pure excludes. It means "not coded here". A type 1 excludes note indicates that the code excluded should never be used at the same time as S32.5. The smartphone market is a fiercely competitive one, with two major players vying for the top spot: Android and iPhone. Both offer powerful features and sleek designs, but which on...Acetabular Fractures. An acetabular fracture is a break in the socket portion of the "ball-and-socket" hip joint. These hip socket fractures are not common — they occur much less frequently than fractures of the upper femur or femoral head (the "ball" portion of the joint). The majority of acetabular fractures are caused by some type of high ...The pelvic bone or pubis is the smallest part of the hip bone. It consists of a small body situated anteromedially and two rami, superior pelvic ramus and inferior pelvic ramus, extending posterolatery from the body. The rami of the pelvic bone resemble the letter ‘K’ from an anterior view. Together, these two rami enclose part of the ...We would like to show you a description here but the site won’t allow us.the most common pelvic injuries is the LC type I, which is an injury to the superior and inferior pubic rami as well as impaction to the sacrum. The great majority of patients are treated nonsurgically with weight bearing to tolerance on the affected side and have a low risk of displace-ment.9 Considerable controversy sur-rounds the optimal ...Figure 7.4.1 7.4. 1: Pelvis. The pelvic girdle is formed by a single hip bone. The hip bone attaches the lower limb to the axial skeleton through its articulation with the sacrum. The right and left hip bones, plus the sacrum and the …The pubis is the smallest of these three bones. It is located at the anteroinferior aspect of the pelvis. The pubis consists of a body and two rami (superior and inferior). Located on the anterior aspect of the pubic body is a bony thickening called the pubic crest. The lateral aspect of this crest is the pubic tubercle.Pubic Rami fractures are most common in the elderly as a result of a fall from a standing position or in those involved in a motor vehicle accident. A patient may experience groin … Pelvic radiograph shows lateral compression injuries. A laterally directed force causes inward rotation of the left hemipelvis with left superior and inferior pubic rami fractures (white arrows). Posteriorly, an impaction fracture of the ipsilateral sacral ala can be seen, with disruption of the sacral arcuate lines (black arrows). Overall, 53% of patients who received further imaging were diagnosed with a combined fracture of the public ramus and sacrum, and 9% (n=1) with a combined fracture of the pubic ramus and the ilium. Furthermore, 23 patients had acute pelvic fragility fractures identified on CT or MRI, in the presence of normal X-rays.Physiotherapy assessment will often find pain on certain tests and tenderness on palpation of the inferior pubic rami. Bone scan, CT and MRI may be used to identify stress fractures and bony oedema. Inferior pubic stress fractures need 6-12 weeks rest, with the latter 6 weeks involving a gradual return to loading/running program.L: undisplaced superior ramus # R (Torode & Zeig III) R: displaced R and L inferior and superior rami# (Torode&Zeig III) Torode & Zeig IV. Fracture near left SI joint and fracture through left superior and inferior pubic rami Torode IV injury with pubic diastasis and SI joint disruption Mature Pelvis: Lateral Compression typeOct 30, 2023 · The hip bone is formed from the fusion of three separate bones, the ilium, ischium, and pubis. The pubis is the smallest of these three bones. It is located at the anteroinferior aspect of the pelvis. The pubis consists of a body and two rami (superior and inferior). Located on the anterior aspect of the pubic body is a bony thickening called ... The female groin is the junction at which folds of the abdomen are joined with the thighs on the sides of the human body. The pubic area of females is located between the two groin...Pelvic radiograph shows lateral compression injuries. A laterally directed force causes inward rotation of the left hemipelvis with left superior and inferior pubic rami fractures (white arrows). Posteriorly, an impaction fracture of the ipsilateral sacral ala can be seen, with disruption of the sacral arcuate lines (black arrows).Radiograph (a) demonstrates an expansile osseous lesion with periosteal reaction and maturing callus along the left superior pubic ramus (arrow). No definite fracture line is identified. Coronal STIR (b) of the pelvis demonstrates bone marrow edema throughout the left superior pubic ramus, fracture site, and surrounding callus (arrow). B: bladder.The minimally displaced fractures of the superior and inferior pubic rami ( Fig. 8-13 B ) were also associated with ipsilateral sacral fractures. ... fracture of the inferior pubic ramus and questionable fracture of the body of the pubis are shown on the AP view of the left pubis ( Fig. 8-14 A ). Note the break in the superior cortex of the ...The pubis consists of a body and two rami (superior and inferior). Located on the anterior aspect of the pubic body is a bony thickening called the pubic crest. The lateral aspect of this crest is the …Gross anatomy Osteology. The pubic bone has an anteromedial body, a superior ramus passing upwards to the acetabulum and an inferior ramus bordering the obturator foramen which joins the ischial ramus (conjoined ramus or the ischiopubic ramus).. The body of pubis is flattened and has an anterior, posterior, and symphyseal surface.. …The most common sites of POFs include the pubic rami, sacrum, ilium, and acetabulum. Combined pubic rami (PROFs) and sacral osteoporotic fractures (SOFs) have been reported, mostly in retrospective studies, describing the mechanism of injury and incidence. The aim of this study was to evaluate the association between PROFs and …Short description: Fracture of superior rim of left pubis, init for clos fx The 2024 edition of ICD-10-CM S32.512A became effective on October 1, 2023. This is the American ICD-10-CM version of S32.512A - other international versions of ICD-10 S32.512A may differ.The ring of this girdle is closed in the anterior by the pubic symphysis between the left and right pubic bones, and in the posterior between the left and right ilia and the sacrum at the sacroiliac joints. The pelvic spine consists of the sacrum and coccyx. Together these two parts form the bony pelvis. Go to: Structure and Function. The pubic rami are a group of bones that make up part of the pelvis. A pubic ramus fracture is a break in one of these bones. These fractures do not need an operation and will heal with time, analgesia and therapy. They often take about 6-8 weeks to heal. You can fully weight bear as pain allows and there are no limitations to The inferior pubic ramus is a thin and flat bone that makes up one third of the pubis. It passes laterally and downward from the medial end of the superior ramus, and becomes narrower as it descends and joins with the inferior ramus of the ischium below the obturator foramen. 7.7C: Pubis is shared under a CC BY-SA license and was authored ...Fracture near left SI joint and fracture through left superior and inferior pubic rami Torode IV injury with pubic diastasis and SI joint disruption Mature Pelvis: Lateral Compression type ... The lateral force has also …2. Superior Pubic Ramus. The superior pubic ramus is one-third of the pubic bone. It starts at the pubic tubercle and extends posterolaterally and upwards to the acetabulum, joining the ilium and ischium. It appears triangular in cross-section, having three surfaces.Superior Pubic Ramus. The structure indicated is the superior pubic ramus. The pelvic bone consists of three components: Ilium; Pubis; Ischium; The pubis is …A fractured pubic rami is a break to the bones that form part of the pelvis. This can be a serious injury, especially in the elderly. Fractured pubic rami injuries typically take between 4 and 6 weeks to heal, although recovery time can be longer for severe fractures. Fractured pubic rami. The pubic ramus is the name for the superior ramus and ...Oct 11, 2017 ... ... left superior and inferior pubic rami, right inferior pubic ramus, and left acetabular anterior column. The additional inlet and outlet ...INTRODUCTION. The pubic symphysis is a non-synovial joint that connects the right and left superior pubic rami with a normal radiographic separation width of 4 to 5 mm. Due to hormone-related changes and physiological alterations observed during pregnancy, the gap can increase by 2-3 mm and remain after delivery, such a separation …Apr 19, 2012 · Radiograph (a) demonstrates an expansile osseous lesion with periosteal reaction and maturing callus along the left superior pubic ramus (arrow). No definite fracture line is identified. Coronal STIR (b) of the pelvis demonstrates bone marrow edema throughout the left superior pubic ramus, fracture site, and surrounding callus (arrow). B: bladder. The inferior pubic ramus extends downward to join the ischial ramus. Together, these form the single ischiopubic ramus , which extends from the pubic body to the ischial tuberosity. The inverted V-shape formed as the ischiopubic rami from both sides come together at the pubic symphysis is called the subpubic angle . Pubic rami fractures in athletes are most commonly “stress fractures” that occur due to repetitive hip movements and repetitive loads on the pelvis, like in long distance running. …The most common sites of POFs include the pubic rami, sacrum, ilium, and acetabulum. Combined pubic rami (PROFs) and sacral osteoporotic fractures (SOFs) have been reported, mostly in retrospective studies, describing the mechanism of injury and incidence. The aim of this study was to evaluate the association between PROFs and SOFs and to ...Pelvis Fractures in the pediatric population are uncommon injuries that are usually associated with high-energy trauma and are often associated with CNS and abdominal visceral injury. Diagnosis is made with plain radiographs of the pelvis. CT studies may be required in the setting of occult fractures.Pubic Ramus Fracture The most common type of pelvic fracture is an injury to one or both of the pubic ramus bones —two ring-shaped bones located on each side of the lower pelvis. In at least 80 percent of cases, the pubic ramus fractures in two places at once.The inferior pubic ramus (plural: inferior pubic rami) is part of the pubis.It forms the border of the urogenital region of the pelvic outlet, running between the pubic tubercle and ischial tuberosity. Medial to the inferior pubic ramus lies the crus of the clitoris in females or penis in males. Superomedially lies levator ani muscle and directly …Detection of posterior pelvic injuries in fractures of the pubic rami. Injury 2012;43(8):1326–1329. Crossref, Medline, Google Scholar; 31. Starks I, Frost A, Wall P, Lim J. Is a fracture of the transverse process of L5 a predictor of pelvic fracture instability? J Bone Joint Surg Br 2011;93(7): 967–969. Crossref, Medline, Google Scholar; 32.This patient is a 71–year-old man who sustained a ground level fall with inability to bear weight on his left side. Initial x-rays of the pelvis were negative (A-C). Magnetic resonance imaging (MRI) scan demonstrated a nondisplaced left sacral fracture (D) and left superior pubic ramus fracture (E).We present a case of an elderly man who sustained non-displaced fractures through the right superior and inferior pubic rami after a fall from standing and had a tragic outcome. While minimally displaced pubic ramus fractures are typically stable and require only symptomatic treatment, there have been reports, such as this one, of low-energy ...Pubic Rami Fracture. Fracture of the anterior pelvic ring, can be the superior and/or inferior pubic rami. Co-existing posterior pelvic ring fracture (e.g. acetabulum, sacrum) Fracture on both sides of pelvis. Unstable pelvis. Blood vessels in and surrounding the bone rupture during injury. Blood accumulates under the skin.Pelvis Fractures in the pediatric population are uncommon injuries that are usually associated with high-energy trauma and are often associated with CNS and abdominal visceral injury. Diagnosis is made with plain radiographs of the pelvis. CT studies may be required in the setting of occult fractures.In today’s fast-paced world, music and entertainment have become an integral part of our daily lives. With the advent of technology, radio has evolved, and one of the most popular ...The pubic bone or pubis is the last and smallest of the hip bones to be discussed. It has a small body located medially and two rami (superior and inferior) extending posterolaterally. The rami of the pubic bone resemble the oblique lines of the letter ‘K’ from an anterior view. Parts and surfacesIn this tutorial we take you through the anatomy of the pelvis using our 3D anatomy model and discuss the features and management approach of stable and unst...Nov 22, 2011 ... Radiographs revealed a left iliopubic rami fracture and nondisplaced right ischiopubic rami fracture. ... The connection passes over the superior ...When it comes to replacing engines, Briggs replacement engines are the superior choice for both residential and commercial applications. With a long-standing reputation for excelle... The body of the pubis articulates with the pubis of the opposite hip bone at the pubic symphysis. The superior margin of the pubic body has the pubic tubercle. The pubis is joined to the ilium by the superior pubic ramus, the superior surface of which forms the pectineal line. The inferior pubic ramus projects inferiorly and laterally. Clinical example of a right-sided retrograde superior pubic medullary screw skin incision is identified by the contralateral left-sided anterior pubic skin staples. a–f For antegrade superior pubic ramus medullary screw fixation, a thin-diameter wire is used first to identify the optimal insertion site on the inlet (a) and combination ...Introduction. Fractures of the pubic rami due to low energy trauma are common in the elderly, with an incidence of 26 per 100,000 people per year in those aged more than 60 years [1, 2].Pubic ramus fractures combined with a sacroiliac joint complex injury is a pelvic fracture, its incidence is increasing due to the development of …... pelvic fracture with an associated left superior pubic ramus fracture. The ... superior/inferior pubic rami fractures had a concomitant posterior pelvic ring ...Short description: Fx superior rim of unsp pubis, subs for fx w routn heal The 2024 edition of ICD-10-CM S32.519D became effective on October 1, 2023. This is the American ICD-10-CM version of S32.519D - other international versions of ICD-10 S32.519D may differ.It was confirmed that the left superior pubic ramus is also fractured. The exam revealed a left iliac wing fracture as well. Case Discussion. Pubic rami fractures are a subgroup of …Nov 19, 2021 · Pelvic fractures are found in 10-20% of severe trauma patients and their presence is highly correlated to increasing trauma severity scores 1 . The most significant fractures result from major trauma. Isolated pubic ramus fractures are common and often missed. Pelvic fractures in children are rare and often the result of high-energy trauma 2 . Pelvic insufficiency fractures are typically occult on plain film unless secondary remodeling has begun. Common locations include the following: sacrum: (sacral insufficiency fracture) ... pubic rami: nearly 90% of fractures at this site occur in conjunction with insufficiency fractures elsewhere within the pelvis;The inferior pubic ramus (plural: inferior pubic rami) is part of the pubis.It forms the border of the urogenital region of the pelvic outlet, running between the pubic tubercle and ischial tuberosity. Medial to the inferior pubic ramus lies the crus of the clitoris in females or penis in males. Superomedially lies levator ani muscle and directly …Thus, the immobility of the pelvis provides a strong foundation for the upper body as it rests on top of the mobile lower limbs. Figure 8.4.1 8.4. 1: Pelvis The pelvic girdle is formed by a single hip bone. The hip bone attaches the lower limb to the axial skeleton through its articulation with the sacrum. The right and left hip bones, plus the ... The pubic rami are a group of bones that make up part of the pelvis. A pubic ramus fracture is a break in one of these bones. These fractures do not need an operation and will heal with time, analgesia and therapy. They often take about 6-8 weeks to heal. You can fully weight bear as pain allows and there are no limitations to Pubic ramus fracture was an injury of anterior pelvic ring, the anterior pelvic ring plays an important role in maintaining the stability of the pelvis. The purpose of this study was to investigate the effect and indication of percutaneous retrograde pubic screw fixation assisted by hollow pedicle finder for pubic ramus fractures. The clinical data of …(b) Direct X-ray of plasmacytoma, including right superior and inferior pubic ramus, expanding in the bone, causing cortical thinning and destruction in places. (c) Axial T2 sequence magnetic resonance image of a simple bone cyst in right pubic ramus. (d) X-ray of left pubic ramus insufficiency fracture.A pelvic fracture involves damage to the hip bones, sacrum, or coccyx - the bony structures forming the pelvic ring. Due to the inherent structural and mechanical integrity of this ring, the pelvis is a highly stable structure. Therefore, fractures of the pelvis occur most commonly in the setting of a high-impact trauma and are often associated ...Sprain of the superior tibiofibul joint and ligament, l knee. ICD-10-CM Diagnosis Code S32.502B [convert to ICD-9-CM] Unspecified fracture of left pubis, initial encounter for open fracture. Unsp fracture of left pubis, init encntr for open fracture; Left pubic bone fracture; Open fracture of left pubis.Pubic ramus fracture. Hover on/off image to show/hide findings. Tap on/off image to show/hide findings. Click image to align with top of page. Pubic ramus fracture. The obturator ring is incomplete on the right; A fracture passes through the superior and inferior pubic rami; Compare with the normal left sideApr 19, 2012 · Radiograph (a) demonstrates an expansile osseous lesion with periosteal reaction and maturing callus along the left superior pubic ramus (arrow). No definite fracture line is identified. Coronal STIR (b) of the pelvis demonstrates bone marrow edema throughout the left superior pubic ramus, fracture site, and surrounding callus (arrow). B: bladder.

May 29, 2022 · Its superior aspect is marked by a rounded thickening (the pubic crest), which extends laterally as the pubic tubercle. Superior pubic ramus – extends laterally from the body to form part of the acetabulum. Inferior pubic ramus – projects towards the ischium. Together, the superior and inferior rami enclose part of the obturator foramen ... . Hotspot through straight talk

left superior pubic rami

A type 1 excludes note is a pure excludes. It means "not coded here". A type 1 excludes note indicates that the code excluded should never be used at the same time as S32.5.A type 1 excludes note is for used for when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.Gross anatomy Osteology. The pubic bone has an anteromedial body, a superior ramus passing upwards to the acetabulum and an inferior ramus bordering the obturator foramen which joins the ischial ramus (conjoined ramus or the ischiopubic ramus).. The body of pubis is flattened and has an anterior, posterior, and symphyseal surface.. …May 12, 2014 ... ... left superior pubic ramus bone. (b) Anteroposterior pelvic radiograph demonstrating the lesion after thorough curettage and chip bone ...ICD-10-CM S32.591A is grouped within Diagnostic Related Group(s) (MS-DRG v 41.0):. 535 Fractures of hip and pelvis with mcc; 536 Fractures of hip and pelvis without mcc; 963 Other multiple significant trauma with mcc; 964 Other multiple significant trauma with cc; 965 Other multiple significant trauma without cc/mcc; Convert S32.591A to ICD-9-CM. Code …When it comes to protecting your home and loved ones, nothing is more important than choosing the right home security system. With so many options available in the market, it can b...Neoprene work gloves are becoming increasingly popular among workers in various industries due to their superior protection and comfort. This synthetic rubber material offers a wid...S00-S09 - Injuries to the head ; S10-S19 - Injuries to the neck ; S20-S29 - Injuries to the thorax ; S30-S39 - Injuries to the abdomen, lower back, lumbar spine, pelvis and external genitals ; S40-S49 - Injuries to the shoulder and upper arm ; S50-S59 - Injuries to the elbow and forearm ; S60-S69 - Injuries to the wrist, hand and fingers ; S70-S79 - Injuries to the …Oct 30, 2023 · It projects superiorly to join the ilium and the superior ramus of the pubis, and contributes to the acetabulum. Ramus. The ramus of the ischium, extends anteromedially from the inferior aspect of the body to join the inferior pubic ramus. Together, these bony rami form the ischiopubic ramus which is the inferior border of the obturator foramen. Laterally, the superior pubic rami pass into the anterior columns of the acetabula, and the inferior pubic rami act as a bridge between the pubic and the ischial bones. Functionally, the pelvic ring serves as a border for the intrapelvic organs on one hand and is the insertion point of the gluteal hamstrings, the abdominal muscles and the ...Figure 7.4.1 7.4. 1: Pelvis. The pelvic girdle is formed by a single hip bone. The hip bone attaches the lower limb to the axial skeleton through its articulation with the sacrum. The right and left hip bones, plus the sacrum and the …The pubis is joined to the ilium by the superior pubic ramus, the superior surface of which forms the pectineal line. The inferior pubic ramus projects inferiorly and laterally. The pubic arch is formed by the pubic symphysis, the bodies of the adjacent pubic bones, and the two inferior pubic rami..

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