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INFIX versus plating for pelvic fractures with disruption of the symphysis pubis

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Abstract

Purpose

The purpose of this study is to compare INFIX to plating in the treatment of unstable pelvic ring injuries with disruption of the symphysis.

Methods

Twenty-four patients treated with INFIX were compared to 28 patients fixed by plating. All patients had anterior and posterior fixation. Injuries were classified using the Young and Burgess and AO/OTA classification systems. Reductions of the pelvic ring were assessed using the pelvic deformity index (PDI) and symphyseal widening. Patients were contacted to get functional outcomes using the Majeed scoring system and complications were tabulated .

Results

INFIX was inferior to plating at reducing symphyseal widening (INFIX 10.72± 5.0 Plates 6.97 ± 3.39 P = 0.012) but similar in reducing the pelvic deformity index. (INFIX 0.0221± .015 Plates 0.0190 ± .0105 P = 0 .38). Majeed scores were similar 83.95 ± 15.2 (median 89, range 51-100) for INFIX and 77.67± 16.7 (median 79, range 54-100) for plating. Complications included infection (1 (4%) INFIX , 4 (14%) plates), improper hardware placement or failure (2 (8%) INFIX, 3 (11%) plates), and heterotopic ossification (11 (46%) INFIX, 16 (57.1%) plates). Infection in the plated patients was related to urological injury in 3/4 cases.

Conclusions

Plating provides better reduction of the pubic symphysis and requires only one surgery. Outcomes scores were similar. INFIX may be preferable in obese patients, young women of childbearing age or those with urological injury.

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Authors and Affiliations

  1. Wayne State University School of Medicine, Detroit Medical Center, Detroit, MI, USA

    Rahul Vaidya, Adam Jonathan Martin, Matthew Roth, Kerellos Nasr, Petra Gheraibeh & Frederick Tonnos

Authors
  1. Rahul Vaidya
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  2. Adam Jonathan Martin
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  3. Matthew Roth
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  4. Kerellos Nasr
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  5. Petra Gheraibeh
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  6. Frederick Tonnos
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Corresponding author

Correspondence to Adam Jonathan Martin.

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Conflict of interest

Dr. Rahul Vaidya: paid consultant Smith and Nephew 2012- for implant development, Johnson and Johnson Synthes Depuy for implant development of an FDA approved INFIX device that is not the device used in this paper which are off the shelf implants which are readily available.

Speakers board AO North America, Smith and Nephew Trauma.

Institutional research support

Synthes Depuy, Smith and Nephew.

Funding

No funding was received for this study.

Ethical approval

This Study was an IRB approved study at our institution.

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Vaidya, R., Martin, A.J., Roth, M. et al. INFIX versus plating for pelvic fractures with disruption of the symphysis pubis. International Orthopaedics (SICOT) 41, 1671–1678 (2017). https://doi.org/10.1007/s00264-016-3387-9

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  • DOI: https://doi.org/10.1007/s00264-016-3387-9

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