THE FATE OF SYMPHYSIS PUBIS PLATING IN ANTERIOR PELVIC RING INJURIES

Aim Evaluate the outcome and complications of anterior pubic symphysis plating in the stabilisation of traumatic anterior pelvic ring injuries. Methods All patients who underwent pubic symphysis plating in a tertiary referral unit were studied. Fracture classification, type of fixation, complications, and incidence of metalwork failure were recorded. Results Out of 178 consecutive patients, 159 (89%) were studied for a mean of 41 months. There were 121 males and 38 females (mean age 38 years). Symphysis pubic fixation was performed in 105 AO-OTA type B and 54 type C injuries using a Matta symphyseal plate (n = 92), reconstruction plate (n = 65), or DCP (n = 2). Supplementary posterior pelvic fixation was performed in 103 patients. 6 patients required revision for failure of fixation or symptomatic instability of the pubic symphysis. A further 7 patients had metalwork removed for other reasons. Metalwork breakage occurred in 66 patients (42%), at a mean of 17 months. 64 of these 66 patients were asymptomatic and metalwork was left in situ. Conclusions Plate fixation of the symphysis pubis is an effective method of stabilising anterior pelvic ring injuries with a low complication rate. There is a high rate of late metalwork breakage, but this is not clinically significant.