Retrograde transpubic screw fixation of transpubic instabilities

Area of Science:

• Orthopedic surgery
• Trauma management
• Pelvic reconstruction

Background:

• Unstable and severely displaced fractures of the upper pubic ramus pose a significant risk to pelvic organs.
• Restoring pelvic form and function is crucial for patient recovery and mobility.

Purpose of the Study:

• To evaluate the efficacy of transpubic screw fixation for reducing and retaining unstable pelvic fractures.
• To assess the restoration of pelvic form and function following this surgical technique.

Main Methods:

• The study involved 16 patients with displaced upper pubic ramus fractures, utilizing transpubic screw fixation via a Pfannenstiel's incision.
• Image intensification guided the open reduction and screw fixation procedure.
• Postoperative management included controlled weight-bearing mobilization.

Main Results:

• Transpubic screw fixation was performed on 16 patients with pelvic ring injuries (Type A, B, and C).
• No intraoperative complications were reported.
• Two postoperative complications occurred: one rectus hernia and one screw pullout leading to osteomyelitis. The remaining fractures healed within 3 months.

Conclusions:

• Transpubic screw fixation is an effective method for managing unstable pelvic ring fractures.
• The procedure demonstrated a high rate of fracture healing with a low complication profile.