Partial Excision of the Ischial Rami for Post-Osteomalacic Contracted Pelvic Outlet

Although osteomalacia is rare in advanced countries and may arise as a complication of intestinal malabsorption, gastric surgery, or renal tubular defects 2, in India dietary deficiency of vitamin D and other nutrients is still the most important cause of osteomala-cia. We report here a rare case of acute contracture of the pelvic outlet in a patient with old healed osteomalacia, which compressed the vaginal orifice to such an extent as not to allow coitus. Case Report NB.. a twenty-two-year-old woman, had an old, healed case of osteomalacia with acute contracture of the pelvic outlet. She was admitted to M. G. Hospital. Jodhpur. on March 17, 1969, with the complaint of difficulty with coitus because of a bone obstruction in the vagina. The patient had been admitted to this hospital in 1967 with acute osteomalacia with severe anemia and generalized tubercular adenitis, for which she was still being treated. The symptoms ofosteomalacia were mark-edly exacerbated when she delivered a male child by caesarean section in September 1967. All biochemical and laboratory investigations at that time were consistent with typical vitamin D-deficiency osteomalacia. All laboratory tests were normal. A roentgenogram made on March 1, 1969, showed an old rachitic triradiate pelvis