title: Is there a clinical benefit of additional tension band wiring in plate fixation of the symphysis?
abstract: The purpose of this study was to determine whether additional tension band wiring in the plate for traumatic disruption of symphysis pubis has clinical benefits. Therefore, outcomes and complications were compared between a plate fixation group and a plate with tension band wiring group.
  
  
  
  We retrospectively evaluated 64 consecutive patients who underwent open reduction and internal fixation of the symphysis pubis by using a plate alone (n = 39) or a plate with tension band wiring (n = 25). All the patients were followed up for a minimum of 24 months (mean, 34.4 months; range, 26-39 months). Demographic characteristics, outcomes, movement of the metal works, complications, revision surgery, and Majeed functional score were compared.
  
  
  
  Significant screw pullout was relatively significantly more frequently found in the plate fixation group than in the plate with tension band wiring group (P = 0.009). In terms of the overall rate of all-cause revision surgery, including significant loosening, symptomatic hardware, and patient-requested hardware removal during follow-up period, the plate with tension band wiring group showed a significantly lower rate.
  
  
  
  Tension band wiring in combination with a symphyseal plate showed better radiological outcomes, a lower incidence of hardware loosening, and a lower rate of revision surgery than plate fixation alone. This technique would have some potential advantages in terms of avoiding significant movement of plate, symptomatic hardware failure, and revision surgery.
authors.affiliation: Department of Orthopedic Surgery, Chonbuk National University Hospital, Research Institute of Clinical Medicine of Chonbuk National University, Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, South Korea.
authors.forename: Myung-Sik
authors.initials: MS
authors.lastname: Park
authors.affiliation: Department of Orthopedic Surgery, Chonbuk National University Hospital, Research Institute of Clinical Medicine of Chonbuk National University, Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, South Korea. sjyoon_kos@naver.com.
authors.forename: Sun-Jung
authors.identifier: 0000-0003-4943-534X
authors.initials: SJ
authors.lastname: Yoon
authors.affiliation: Department of Orthopedic Surgery, Chonbuk National University Hospital, Research Institute of Clinical Medicine of Chonbuk National University, Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, South Korea.
authors.forename: Seung-Min
authors.initials: SM
authors.lastname: Choi
authors.affiliation: Department of Orthopedic Surgery, Chonbuk National University Hospital, Research Institute of Clinical Medicine of Chonbuk National University, Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, South Korea.
authors.forename: Kwanghun
authors.initials: K
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates / Q000706:statistics & numerical data; D001864:Bone Wires / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011631:Pubic Symphysis / Q000000981:diagnostic imaging / Q000601:surgery; D046548:Pubic Symphysis Diastasis / Q000000981:diagnostic imaging* / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Pelvic ring injury; Plate fixation; Tension band wiring; Traumatic symphysis pubis diastasis