Outcome After Plate Stabilization Of Symphyseal Diastasis

Background. Separation of the pubic symphysis with corresponding diastasis can be stabilized by symphyseal plating.Objective. Which pelvic injuries are stabilized with symphyseal plating and what is their outcome?Material and methods. A retrospective evaluation of 64 patients who underwent symphyseal plating over a period of 24 months was conducted.Results. Of the patients 56 were male and 8 female with a mean age of 44 years (SD +/- 17 years). The main cause of the pelvic injuries were traffic accidents. The distribution according to the AO fracture classification was 14 x B1, 10 x B2, 5 x B3, 23 x C1, 9 x C2 and 3 x C3 injuries. The distribution according to the Young and Burgess classification showed 9 x APC I, 18 x APC II, 13 x APC III, 9 x LC I, 3 x LC II, 2 x LC III and 10 x VS injuries. The mean Injury Severity Score (ISS) was 32 (SD +/- 17) and the mean inpatient stay was 29 days (SD +/- 16 days; positive correlation p <= 0.001). Radiological implant loosening occurred in 52 patients. 14 patients required treatment for severe complications. The leading reason for revision surgery was implant failure (n = 8).Conclusion. These observations suggest that radiological signs of implant loosening are commonly observed but rarely the reason for revision surgery. Complete implant failures, however; occur mainly within the first postoperative weeks and require early revision. A timely clarification by additional X-ray imaging should be carried out if this is suspected.