Internal osteosynthesis of the pubial symphysis injuries. Results evaluation 2020-2024

Abstract

Introduction. Diastasis of the pubic symphysis represents the injury consisted of the loss of the connection between the pubic bones, resulting in the instability of the anterior pelvic ring. The lesion with diastasis exceeding 25 mm is considered the lesion requiring surgical intervention. The goals of treating symphysis diastasis include adequate reduction and stable fixation to ensure pelvic ring stability. Aim of study. Evaluation of the results of osteosynthesis treatment in pubic symphysis lesions, determination of the complication rate, evaluation of long-term results. Methods and materials. We analyzed 31 clinical cases: 27 men and 4 women; The average age was 51.23 years. All were investigated by pelvic CT. All suffered unstable pelvic fractures type B and C, according to the Tile classification. The cause of trauma was: 19 cases of road accidents, 9 cases of catatrauma, 2 cases of crushing. The average hospitalization period was 27.64 days and 9.76 days in 13 people with strict pelvic injuries. All studies underwent surgical treatment (1 – external fixation, 5 – external fixation with subsequent conversion, 8 –osteosynthesis of the anterior part of pelvic ring, 19 – anterior osteosynthesis supplemented by fixation of the posterior part of pelvic ring). Results. All studies were followed post-surgery for 1, 3, 6, 12 months. Osteosynthesis degradation occurred in 3 patients, postoperative infection in 4 patients, lethal results in 4 patients caused by severe trauma and comorbidities. Conclusion. The best results and fewer complications were achieved in a close and personalized approach to the cases, with both pelvic halves fixed and a good patient's compliance.