Morris SA. Clin Orthop Relat Res. 2012. doi: 10.1007/s11999-012-2427-z
The high rate of late fixation failure following plate fixation of the symphysis is not clinically important, according to researchers in the United Kingdom.
The researchers performed a retrospective review of 148 patients who underwent plate fixation for treatment of traumatic symphysis pubis diastasis between 1994 and 2008. The review included an analysis of radiographs, pelvic fracture classification, fixation method, fixation failure incidence, mode and timing of failure and any complications. Minimum follow-up for the study was 12 months, with a range of 1 year to 14 years.
According to the study abstract, the authors found hardware breakage in 63 patients (43%), with 61 being asymptomiatic. The authors also found that fracture classification, type of plate and posterior pelvic fixation were all unrelated to breakage.
“Five patients (3%) required revision surgery for failure of fixation or symptomatic instability of the symphysis pubis, and seven patients (5%) had removal of hardware for other reasons, including late deep infection in three (2%),” the authors wrote.
They added that management was not altered by radiographic screening as part of annual follow-ups following the first year.