title: INFIX versus plating for pelvic fractures with disruption of the symphysis pubis.
abstract: The purpose of this study is to compare INFIX to plating in the treatment of unstable pelvic ring injuries with disruption of the symphysis.
  
  
  
  Twenty-four patients treated with INFIX were compared to 28 patients fixed by plating. All patients had anterior and posterior fixation. Injuries were classified using the Young and Burgess and AO/OTA classification systems. Reductions of the pelvic ring were assessed using the pelvic deformity index (PDI) and symphyseal widening. Patients were contacted to get functional outcomes using the Majeed scoring system and complications were tabulated .
  
  
  
  INFIX was inferior to plating at reducing symphyseal widening (INFIX 10.72± 5.0 Plates 6.97 ± 3.39 P = 0.012) but similar in reducing the pelvic deformity index. (INFIX 0.0221± .015 Plates 0.0190 ± .0105 P = 0 .38). Majeed scores were similar 83.95 ± 15.2 (median 89, range 51-100) for INFIX and 77.67± 16.7 (median 79, range 54-100) for plating. Complications included infection (1 (4%) INFIX , 4 (14%) plates), improper hardware placement or failure (2 (8%) INFIX, 3 (11%) plates), and heterotopic ossification (11 (46%) INFIX, 16 (57.1%) plates). Infection in the plated patients was related to urological injury in 3/4 cases.
  
  
  
  Plating provides better reduction of the pubic symphysis and requires only one surgery. Outcomes scores were similar. INFIX may be preferable in obese patients, young women of childbearing age or those with urological injury.
authors.affiliation: Wayne State University School of Medicine, Detroit Medical Center, Detroit, MI, USA.
authors.forename: Rahul
authors.initials: R
authors.lastname: Vaidya
authors.affiliation: Wayne State University School of Medicine, Detroit Medical Center, Detroit, MI, USA. admartin@med.wayne.edu.
authors.forename: Adam Jonathan
authors.initials: AJ
authors.lastname: Martin
authors.affiliation: Wayne State University School of Medicine, Detroit Medical Center, Detroit, MI, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Roth
authors.affiliation: Wayne State University School of Medicine, Detroit Medical Center, Detroit, MI, USA.
authors.forename: Kerellos
authors.initials: K
authors.lastname: Nasr
authors.affiliation: Wayne State University School of Medicine, Detroit Medical Center, Detroit, MI, USA.
authors.forename: Petra
authors.initials: P
authors.lastname: Gheraibeh
authors.affiliation: Wayne State University School of Medicine, Detroit Medical Center, Detroit, MI, USA.
authors.forename: Frederick
authors.initials: F
authors.lastname: Tonnos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D011631:Pubic Symphysis / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D012189:Retrospective Studies; D055815:Young Adult
keywords: AO/OTA classification; APC injuries; Anterior subcutaneous pelvic fixator; Heterotopic ossification; INFIX; Majeed score; Pelvic deformity index; Pelvic fracture; Pelvic ring injury; Symphyseal disruption; Symphyseal plating; Young and Burgess classification