Operative Treatment of Symphyseal Disruption

Min, Byung Woo; Jeon, Si Hyun

Abstract

PURPOSE
To evaluate the efficacy of open reduction and internal fixation for disrupted symphysis pubis in unstable pelvic injuries.
MATERIALS AND METHODS
Eighteen symphyseal disruptions were treated by open reduction and internal fixation from 1994 to 1998. There were 12 Tile type B and six type C injuries. In 12 patients, anterior fixation was performed whereas six patients were treated by anterior and posterior fixation. The clinical and radiological results were reviewed retrospectively at a mean of 20.4 months (range, 12 to 44 months) .
RESULTS
The average symphyseal displacement improved from a preoperative value of 37.3 mm (range, 10-87 mm) to a postoperative value of 6.5 mm (range, 2-14 mm) . Leg length discrepancy which averaged 11.8 mm (range, 4-30 mm) preoperatively was decreased to 2.3 mm (range, 0-7 mm) postoperatively. Open reduction and internal fixation was associated with a higher percentage of excellent results except in osteoporotic bone. Two patients with osteoporosis had a loss of fixation. Complications were infrequent.
CONCLUSION
Open reduction and internal fixation are desirable techniques for symphyseal disruption. But the supplemental wire fixation with plate would be recommended for elderly patients who show obvious signs of osteoporosis.