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Symphyseal plate with trans-symphyseal cross-screws for fixation of tile-type B1 pelvic ring injuries: radiological and functional evaluation

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Abstract

Introduction

Failure to neutralize the different physiological forces acting on the inferior as well as the superior regions of the pubic symphysis, the long healing time, is blamed for the repeated failures of conventional superior symphyseal plating.

Material and methods

A three years prospective case series study between January 2017 and December 2019 was done, to evaluate the radiological and the functional outcomes, using Matta/Tornetta and Majeed criteria respectively, of the combination of trans-symphyseal cross-screws configuration and superior symphyseal plate in Tile-type B1 pelvic injuries.

Results

Thirty patients, 18 with anteroposterior compression type II and 12 with type III, with a mean follow-up of 20 months ±5 were included. Radiologically, 26 (86.6%) cases showed an excellent, one (3.3%) good and three (10%) fair outcome. Clinically, excellent outcome in 26 (86.6%) cases, good in two (6.6%) cases, and fair in two (6.6%). Intra-operative drill bit breakage occurred in three (10%) cases and was the only reported technical complication. Significant re-displacement was reported in three (10%) cases.

Conclusion

The open trans-symphyseal cross-screws for fixation of the superior symphyseal plate is a simple, efficient, and safe technique with the biomechanical advantages of an extra-fixation point to the inferior symphysis together with a long and a strong bony anchorage.

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Authors and Affiliations

  1. Pelvic Trauma and Arthroplasty Unit, Department of Orthopaedics and Traumatology, Kasr-Alainy Hospital, Cairo University, Cairo, Egypt

    Fady Kamal Beder, Mohamed Salama Hamdy, Ihab Ibraheem El-Desouky, Khaled Fawzy Abdelkader & Ahmed Hazem Abdelazeem

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  1. Fady Kamal Beder
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  2. Mohamed Salama Hamdy
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  3. Ihab Ibraheem El-Desouky
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  4. Khaled Fawzy Abdelkader
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  5. Ahmed Hazem Abdelazeem
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Correspondence to Ahmed Hazem Abdelazeem.

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Beder, F.K., Hamdy, M.S., El-Desouky, I.I. et al. Symphyseal plate with trans-symphyseal cross-screws for fixation of tile-type B1 pelvic ring injuries: radiological and functional evaluation. International Orthopaedics (SICOT) 44, 2745–2751 (2020). https://doi.org/10.1007/s00264-020-04851-z

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