Techniques for operative reduction of pubic symphysis disruptions

Occasionally, a pelvic fracture is an exceedingly difficult injury to manage in the multiple trauma victim. Accompanying hemorrhage can not only be life-threatening but often confuses the evaluation as to sources of blood loss. Reduction of a Malgaigne's or open book pelvic fracture aids significantly in stemming this extraperitoneal venous bleeding. If operative intervention for associated injuries is required, reapproximation of any pubic disruption should be performed concomitantly. Use of the rib approximator for this reduction saves considerable time and can be accomplished with relatively little effort.