Clinical and radiological outcomes following symphysis-bridging plate osteosynthesis in pelvic ring injuries

Background

The aim of the study was to compare clinical and radiological outcomes following symphysis-bridging plate osteosynthesis among patients with pelvic ring injuries and concomitant traumatic symphysis rupture.

Methods

This retrospective single-center cohort-study included patients with operatively treated unstable pelvic ring injuries with traumatic symphysis rupture between 2010 and 2023 at an academic level one trauma center. Two cohorts were extracted based on the method of osteosynthetic stabilization: primary (PrimOS) or secondary symphyseal plating following initial treatment with external fixation (SecOS). Main outcome measures were quality of radiological injury reduction, and short-term clinical outcomes as indicated by in-hospital complications and adequacy of re-mobilization.

Results

46 patients with a median age of 45 years and a median ASA score of 2 were included in this study. 25 patients (54,3%) received PrimOS, while 21 patients (45,7%) received SecOS. The study groups did not differ significantly in terms of postoperative radiological reduction quality or mortality rate. Overall complication rates were significantly higher in the SecOS group (PrimOS 28,0% vs SecOS 57,1%, p<0,05). Patients treated initially with external fixation of the pelvis were associated with significantly longer median length of hospital stay (LOS) (PrimOS 13,0d vs SecOS 20,0 d, p<0,05) and a significantly prolonged median remobilization period into standing/gait (PrimOS 3,0d vs SecOS 4,0d, p<0,05).

Conclusions

Primary plate osteosynthesis of the symphysis in patients with pelvic ring injuries and concomitant traumatic symphysis rupture seems to be associated with less overall complications, shorter LOS and faster remobilization into standing/gait. This could underscore the possibility for prioritization of primary definitive fixation of these injuries, whenever feasible.

No