A biomechanical cadaver comparison of suture button fixation to plate fixation for pubic symphysis diastasis

•Suture button fixation of the pubic symphysis is biomechanically similar to plate osteosynthesis.•Suture button fixation of the pubic symphysis trends toward higher load to failure than plate osteosynthesis.•Further clinical research of suture button fixation of the pubic symphysis is warranted. To determine whether suture button fixation of the pubic symphysis is biomechanically similar to plate fixation in the treatment of partially stable pelvic ring injuries. Twelve pelvis specimens were harvested from fresh frozen cadavers. Dual-x-ray-absorptiometry (DXA) scans were obtained for all specimens. The pubic symphysis of each specimen was sectioned to simulate a partially stable pelvic ring injury. Six of the pelvises were instrumented using a 6 hole, 3.5 mm low profile pelvis plate and six of the pelvises were instrumented with two suture button devices. Biomechanical testing was performed on a pneumatic testing apparatus in a manner that simulates vertical stance. Displacement measurements of the superior, middle, and inferior pubic symphysis were obtained prior to loading, after an initial 440 N load, and after 30,000 and 60,000 rounds of cyclic loading. Statistical analysis was performed using Wilcoxon-Mann-Whitney tests, Fisher’s exact test, and Cohen’s d to calculate effect size. Significance was set at p