[Outcome after plate stabilization of symphyseal diastasis]

Separation of the pubic symphysis with corresponding diastasis can be stabilized by symphyseal plating.

Which pelvic injuries are stabilized with symphyseal plating and what is their outcome?

A retrospective evaluation of 64 patients who underwent symphyseal plating over a period of 24 months was conducted.

Of the patients 56 were male and 8 female with a mean age of 44 years (SD ± 17 years). The main cause of the pelvic injuries were traffic accidents. The distribution according to the AO fracture classification was 14 × B1, 10 × B2, 5 × B3, 23 × C1, 9 × C2 and 3 × C3 injuries. The distribution according to the Young and Burgess classification showed 9 × APC I, 18 × APC II, 13 × APC III, 9 × LC I, 3 × LC II, 2 × LC III and 10 × VS injuries. The mean Injury Severity Score (ISS) was 32 (SD ± 17) and the mean inpatient stay was 29 days (SD ± 16 days; positive correlation p ≤ 0.001). Radiological implant loosening occurred in 52 patients. 14 patients required treatment for severe complications. The leading reason for revision surgery was implant failure (n = 8).

These observations suggest that radiological signs of implant loosening are commonly observed but rarely the reason for revision surgery. Complete implant failures, however; occur mainly within the first postoperative weeks and require early revision. A timely clarification by additional X-ray imaging should be carried out if this is suspected.