Plating with posterior fixation provided significant reduction in symphysis pubis

NATIONAL HARBOR, Md. — Plating with posterior fixation provided a greater reduction in patients with unstable pelvic injuries who had disruption of the symphysis pubis compared to implantation of anterior subcutaneous internal fixator, according to speaker here at the Orthopaedic Trauma Association Annual Meeting.

“Diastasis of the pubis symphysis frequently occurs in traumatic, unstable pelvic brain injuries, usually due to [anterior posterior compression] or vertical sheer mechanisms [and are] rarely due to lateral compression mechanisms, Adam Martin, MS, of the Detroit Medical Center at Wayne State University, said. “Addressing the symphyseal diastasis is an important aspect of stabilizing the pelvic ring.

Martin and his colleagues used their hospital’s trauma database, which included 52 patients with unstable pelvic injuries who had symphysis pubis (SP) disruptions. Researchers compared 28 patients who underwent SP plating with posterior fixation with 24 patients underwent implantation of anterior subcutaneous internal fixator (INFIX) with posterior fixation.

According to Martin, results showed that mean reduction of SP was 63.48% of the original diastasis in the INFIX group compared with 75.25% in the plating group.

Based on the pain disability index values, mean reduction of the pelvic ring was 54.15% in the plating group compared with 14.96% in the INFIX group.

There were no statistically significant differences between the two groups in complication rates and Majeed outcome scores.

“We think [plating] might help patients [who have] neurological injuries or who are obese, but outside of that, the plates are a much better reduction tool,” Martin said. – by Dan O’Neill

Reference:

Martin A. Paper #53. Presented at: Orthopaedic Trauma Association Annual Meeting; Oct. 4-8, 2016; National Harbor, Md.

Disclosure: Martin reports no relevant financial disclosures.