Retrograde locked nailing of pubic ramus fractures: a technical note

Percutaneous screwing of the pubic ramus presents several limitations, such as the infeasibility within a bone corridor that is too narrow or too curved, or the lack of proximal locking, which may result in the mobilization of implants. This technical note presents an original method for percutaneous fixation of pubic ramus fractures using retrograde locked nailing. The implant used is the fibula rod system (Acumed), a proximally locking fibula nail. Four patients underwent surgery for pelvic ring fractures with anterior fixation using this technique, allowing immediate weight-bearing. All the patients had no corridor for a 6.5 mm canulated screw according to our pre-operative planning. No intra- or postoperative complications were observed. Further studies on fracture consolidation are required in larger series with longer radio-clinical follow-up. Retrograde locked nailing of pubic ramus fractures offers a new solution for anterior pelvic ring fixation, addressing the various limitations associated with retrograde screwing.Level of evidence: IV Retrospective study.