Clinical study on the treatment of pubic symphysis diastasis with modified internal fixation

There are various treatment methods for pubic symphysis diastasis, this study explores the advantages and limitations of using a modified internal fixator to treat pubic symphysis diastasis.

A total of 31 patients with pubic symphysis diastasis were treated with modified internal fixator at our institution from January 2020 to January 2024, and the clinical data of these patients were retrospectively analyzed. Patient data collected included age, gender, cause of injury, fracture typing, incision length, operative time, intraoperative bleeding, time from injury to surgery, quality of reduction, complications, and postoperative function. The quality of reduction was assessed using the Matta radiologic criteria, and the degree of functional recovery after pelvic fracture was evaluated using the Majeed scale at follow-up.

According to AO/OTA staging, 20 patients with type B2 were treated with modified internal fixator combined with 1 sacroiliac screw, 6 patients with type C1 were treated with modified internal fixator combined with 2 sacroiliac screws, and 5 patients with type C1 were treated with modified internal fixator combined with posterior spinal pelvic triangular fixation. The patients' surgical incision length was 4.0-5.3 cm, mean 4.75 cm, intraoperative bleeding was 68-101 ml, mean 85.58 ml, operative time was 55-77 min, mean 64.39 min, width of the pubic symphysis was 4.4-6.6 mm, mean 5.45 mm and the injury-to-operative time was 3-13 days, mean 7.03 days. The Majeed score was 90.23 points (range 81-96 points), with 25 cases with excellent and 6 cases with good, with an excellence rate of 100%. According to the Matta scale, there were 21 excellent cases and 10 good cases, with an excellent rate of 100%.

In conclusion, the findings of this retrospective study preliminarily indicate that the M-INFIX is a promising, minimally invasive treatment option for pubic symphysis diastasis. The technique demonstrated satisfactory radiographic reduction, excellent functional recovery, and a low complication rate in our patient cohort. However, it is important to emphasize that the retrospective design and relatively small sample size limit the generalizability of these findings.​ Therefore, the exact efficacy and comparative advantages of M-INFIX warrant further validation through larger-scale, prospective, randomized controlled studies.