title: [Treatment of trans-symphyseal instability with an internal fixator. Outcome of a surgical technique on the basis of a case report].
abstract: Treatment of traumatic trans-symphyseal instability by internal plate fixation is the most common procedure. Besides the trauma-induced muscle damage, the implantation induces additional damage at the symphyseal origin of the m. rectus abdominis. The aim of this clinical case study was to examine whether it is possible to reduce the iatrogenic soft tissue damage while correcting trans-symphyseal instability using an internal fixator. After a transverse skin incision, two pedicle screws were drilled into the corpus ossis pubis next to the symphysis. Afterwards the crossbar was implanted and fixed. Generally, implantation of two self-trapping pedicle screws using a skin incision with a length of 6 cm is possible. Additional detachment of the m. rectus abdominis is not necessary. As a result of the mobility of the skin and subcutaneous tissue, the implantation of the crossbar beneath the m. rectus abdominis is possible. Stabilization of traumatic trans-symphyseal instability by internal fixation is a safe and easy method. Additional soft tissue damage can be prevented, but to achieve multidirectional stability some small modifications of the implant are necessary.
authors.affiliation: Chirurgische Klinik, Bundeswehrkrankenhaus, Ulm. christian_willy@hotmail.com
authors.forename: C
authors.initials: C
authors.lastname: Willy
authors.forename: R
authors.initials: R
authors.lastname: Schmidt
authors.forename: H
authors.initials: H
authors.lastname: Gerngross
authors.forename: B
authors.initials: B
authors.lastname: Friemert
mesh_terms: D001860:Bone Plates; D001863:Bone Screws; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D016268:Internal Fixators; D007593:Joint Instability / Q000175:diagnosis* / Q000601:surgery*; D011631:Pubic Symphysis / Q000293:injuries* / Q000601:surgery*; D016896:Treatment Outcome