Initial reduction with nonabsorbable polyester for a widely disrupted pubic symphysis with perineal involvement

An 18-year-old male sustained a huge open fracture of the pubic symphysis combined with perineal trauma in a motor vehicle accident. Physical examination in our emergency department revealed a huge contaminated deep perineal open wound about 15 cm in length with rectal perforation. The radiographs showed an open book fracture (Type B1) of the pubic symphysis 9 cm in length, fracture of the left femoral middle shaft, and fracture of the left radius. After fluid administration and blood transfusion, the patient underwent a diverting colostomy, wide debridement, and reduction of the pubic symphysis with two figure-of-eight sutures of nonabsorbable polyester. This fixation option was easily and quickly applied, and had adequate strength for rehabilitation. The infection in the pelvis was regional and well controlled after antibiotic treatment. The functional outcome showed that the patient was satisfied with pain relief, and there was good bone healing and weight-bearing ambulation.