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Radiographic Changes After Pubic Symphysis Plating and Their Clinical Relevance: An Exploratory Longitudinal Cohort

Adrian Claudiu Carp¹, Bogdan Veliceasa¹, Awad Dmour¹

¹Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.

Life (Basel, Switzerland)

|May 27, 2026

Summary

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Early pubic symphysis plating failure is rare and identified by symptoms, not just imaging changes. Postoperative widening often occurs without clinical issues, suggesting imaging should be interpreted alongside patient symptoms.

Area of Science:

Orthopedic surgery
Trauma surgery
Radiology

Background:

Pubic symphysis plating is common for traumatic disruptions.
Reported implant failure rates vary widely.
Variability may stem from inconsistent definitions and failure to distinguish clinical failure from asymptomatic radiographic changes.

Purpose of the Study:

To evaluate the incidence and significance of early mechanical failure versus later radiographic changes after pubic symphysis plating.
To differentiate clinically significant failure from asymptomatic postoperative radiographic findings.

Main Methods:

Retrospective observational study of 30 patients with traumatic pubic symphysis disruption treated with plate fixation.
Measured pubic symphysis distance (PSD) on CT and radiographs at multiple time points.

Keywords:

mechanical failure pelvic ring injury postoperative widening pubic symphysis pubic symphysis plating radiographic loosening

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Defined and assessed early mechanical failure, implant loosening, and loss of reduction.

Main Results:

Early mechanical failure occurred in 13.3% of patients within 30 days, presenting as symptomatic construct compromise requiring revision.
Later radiographic signs of implant loosening and widening were observed in 26.7% without clinical symptoms or need for revision.
Longitudinal PSD changes were significant, with most widening occurring between 3 and 6 months postoperatively.

Conclusions:

Postoperative radiographic widening and implant loosening signs alone are not associated with clinically evident failure requiring revision.
Early failure is characterized by acute symptoms and imaging-confirmed construct compromise.
Postoperative imaging should be interpreted in conjunction with clinical symptoms and overall pelvic stability.