Anterior pelvic ring fractures: a proposal of a variant of osteosynthesis of the pubic symphysis

Different internal fixation techniques (ORIF) have been proposed for the reduction and stabilization of traumatic diastase of the pubic symphysis: two-hole plates, multi-hole plates and double plates. Classically the synthesis of the symphysis is executed with 2 plates of 3.5 or 4.5 mm (anterior and sovrapubic), where screws are inserted from anterior to posterior. Since 2005 to January 2008, the first author has treated 16 patients modifying the anterior screws positioning for the stabilization of the pubic symphysis. In the 16 considered cases we have positioned just 2 anterior screws, one for each pubic branch, in the conviction of a better respect of the physiological forces lines. All the screws have a length from 55 to 65 mm. Functional results were excellent in 90%, good in 10%; reductions resulted excellent in 90% and good in 10%. The modified screws fixation method could be proposed in the management of treatment of anterior unstable pelvic ring.