TITLE

A comparison of percutaneous reduction and screw fixation versus open reduction and plate fixation of traumatic symphysis pubis diastasis

AUTHOR(S)
Chen, Linwei; Zhang, Guoyou; Song, Dianwen; Guo, Xiaoshan; Yuan, Wen
PUB. DATE
February 2012
SOURCE
Archives of Orthopaedic & Trauma Surgery;Feb2012, Vol. 132 Issue 2, p265
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Purpose: Plate fixation, the conventional treatment for traumatic symphysis pubis diastasis, carries the risk of extensive exposure, blood loss and postoperative infections. Percutaneous screw fixation is a minimally invasive treatment. The goal of the present study was to compare the outcome of plate fixation and percutaneous screw technique in the treatment of traumatic pubic symphysis diastasis. Methods: Ninety patients with traumatic symphysis pubis diastasis were treated from January 2003 to December 2009 at two level 1 regional trauma centers. The mean time of follow-up was 21 months (18 to 26). Forty-five patients were treated by percutaneous screw fixation. Forty-five patients were treated by plate and screws fixation. The demographic, distribution of fracture patterns, blood loss, incision length, fixation failure, malunion, revision surgery and functional scores were compared. Results: Seven cases were lost during follow-up. Demographics (age and gender), fracture classification and Injury Severity Score were comparable in the two groups ( P > 0.05). Blood loss and extensive exposure were much less in screw group ( P < 0.01). Patients in screw group achieved better functional performance ( P = 0.01). There were no significant differences favoring plate fixation in reduction quality ( P = 0.32), implant failure ( P = 0.39), malunion ( P = 0.15), revision surgery rates ( P = 0.27), percentage of impotence in the male patients ( P = 0.2) and implant removal time ( P = 0.12) between the two groups. Conclusions: Our results indicate that besides lower rate of iatrogenic injuries and better functional outcome, percutaneous screw fixation of the pubic symphysis is as strong as plate fixation.
ACCESSION #
70383353

 

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