Abstract
Aim
To evaluate the outcome and complications of pubic symphysis plating in the stabilisation of traumatic anterior pelvic ring injuries.
Methods
All patients who underwent anterior pelvic ring stabilisation with a pubic symphysis plate in a tertiary referral pelvic and acetabular reconstruction unit were studied. Patients were followed up annually for five years with AP, inlet and outlet radiographs at each visit. The fracture classification, type of fixation (including additional posterior fixation), and incidence of metalwork failure were recorded.
Results
In a series of 178 consecutive patients, 159 (89%) were studied for a mean of 41 months (range 3 months to 13 years). There were 121 males and 38 females, with a mean age of 38 years (9-80yrs). Symphysis pubic fixation was performed in 105 AO-OTA type B and 54 AO-OTA type C injuries using a Matta symphyseal plate in 92, a reconstruction plate in 65, or a DCP in two patients. Supplementary posterior pelvic fixation was performed in 103 patients. Six patients (3.8%) required revision for failure of fixation or symptomatic instability of the pubic symphysis. A further seven patients (4%) had metalwork removed for other reasons. Metalwork breakage occurred in 66 patients (42%). 64 of these 66 patients were asymptomatic and metalwork was left in situ.
Conclusion
Plate fixation of the symphysis pubis is an effective method of stabilising anterior pelvic ring injuries with a low rate of complications. There is a high rate of late metalwork breakage, but this is often not clinically significant.
