The Efficacy of Using Trans-Symphyseal Crossing Screws in Symphyseal Plating for the Unstable Antero-Posterior Compression Pelvic Injuries:A Novel Technique and Early Radiological Results

Background and Objective: We hypothesized that the placement of trans-symphyseal crossing screws during symphyseal plating of disrupted pelvic fractures would lead to increase fixation strength and better radiological outcomes.

Methods: The study was a prospective, case-series, study that was conducted on 30 patients with unstable antero-posterior pelvic injury (APC type III). Open reduction and internal fixation with 3.5 reconstruction plate and trans-symphyseal crossing screws was done for the anterior injury and percutaneous iliosacral screw fixation for the posterior injury in all patients.

Results: The mean length of follow-up was 18 ± 5 months. The average length of crossing screws was 80.6 mm. The mean pubic space on final follow up radiograph was 6.4 ± 2.8 mm. The mean pubic space widening was 2.3 ± 1.7 mm. Neither significant pubic space widening (more than 10 mm) nor plate failure was observed.

Conclusion: The novel technique of cross-placement of screws during symphyseal plating could be effective among patients with unstable antero-posterior compression pelvic fractures with high excellent radiological outcomes and low complications and failure rate.