title: A comparison of percutaneous reduction and screw fixation versus open reduction and plate fixation of traumatic symphysis pubis diastasis.
abstract: OBJECTIVE
  Plate fixation, the conventional treatment for traumatic symphysis pubis diastasis, carries the risk of extensive exposure, blood loss and postoperative infections. Percutaneous screw fixation is a minimally invasive treatment. The goal of the present study was to compare the outcome of plate fixation and percutaneous screw technique in the treatment of traumatic pubic symphysis diastasis.
  
  
  METHODS
  Ninety patients with traumatic symphysis pubis diastasis were treated from January 2003 to December 2009 at two level 1 regional trauma centers. The mean time of follow-up was 21 months (18 to 26). Forty-five patients were treated by percutaneous screw fixation. Forty-five patients were treated by plate and screws fixation. The demographic, distribution of fracture patterns, blood loss, incision length, fixation failure, malunion, revision surgery and functional scores were compared.
  
  
  RESULTS
  Seven cases were lost during follow-up. Demographics (age and gender), fracture classification and Injury Severity Score were comparable in the two groups (P > 0.05). Blood loss and extensive exposure were much less in screw group (P < 0.01). Patients in screw group achieved better functional performance (P = 0.01). There were no significant differences favoring plate fixation in reduction quality (P = 0.32), implant failure (P = 0.39), malunion (P = 0.15), revision surgery rates (P = 0.27), percentage of impotence in the male patients (P = 0.2) and implant removal time (P = 0.12) between the two groups.
  
  
  CONCLUSIONS
  Our results indicate that besides lower rate of iatrogenic injuries and better functional outcome, percutaneous screw fixation of the pubic symphysis is as strong as plate fixation.
authors.affiliation: The Second Affiliated Hospital of Wenzhou Medical College, Xueyuan Road 109, Wenzhou, Zhejiang Province 325027, China.
authors.forename: Linwei
authors.initials: L
authors.lastname: Chen
authors.forename: Guoyou
authors.initials: G
authors.lastname: Zhang
authors.forename: Dianwen
authors.initials: D
authors.lastname: Song
authors.forename: Xiaoshan
authors.initials: X
authors.lastname: Guo
authors.forename: Wen
authors.initials: W
authors.lastname: Yuan
mesh_terms: D000328:Adult; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D046548:Pubic Symphysis Diastasis / Q000601:surgery*