Percutaneous screw fixation of pubic symphysis disruption

Percutaneous fixation of the pubic symphysis is a relatively novel treatment strategy in the management of pelvic ring injuries with symphyseal disruption. While the current gold standard for surgical treatment of pubic symphysis diastasis is open reduction and plate fixation, high rates of implant failure and recurrent diastasis persist. Furthermore, blood loss, operative time, and postoperative infection associated with open approaches to the pelvis should be considered. Percutaneous fixation of the posterior pelvic ring has proven to be safe and effective. Percutaneous fixation of the pubic symphysis has been described in China and Spain, with promising results. We present here our surgical technique for percutaneous reduction and fixation of the pubic symphysis with emphasis on the risks to nearby anatomic structures.