Clinical Research Of Open Reduction And Internal Fixation On Floating Injury Of Symphysis Pubis And Clinical Outcomes

Objective:To analysis the clinical characteristics on floating injury of symphysis pubis and clinical outcomes of open reduction and internal fixation.Methods:A retrospective study was conducted to analyze the49patients who had been treated in our department for open reduction and internal fixation for floating symphysis from December2006to January2013.They were32men and17women, with an average age of36.5years(from20to61years). Thirty-five of them were injured in a traffic accident and nine were injured by falling from height, five cases were crushed by machinery. According to the AO classification, there were14cases in B3type,32cases in C2type,2cases in C3type. Forty-five cases in the group complicated with posterior ring of pelvis fractures,15cases complicated with acetabular fractures,22cases complicated with limb fractures,11cases complicated with thoracic and abdominal injuries and6cases associated with craniocerebral injury. The time interval from injury to surgery averaged9days (from3to14days). Surgical methods:All general anesthesias with tracheal intubation. Reconstruction plate fixed bilateral pubic ramus fractures in41cases,,39cases fixation posterior ring of pelvis simultaneously,using front sacroiliac plate fixation in11cases; using sacroiliac screw fixation in5cases; using post-iliac M plate in17cases,8cases of them using cannulated screw fixation by minimally invasive.Results:Recorded and graded according to the method of Tornetta and Matta, The functional outcomes were evaluated using the Majeed score. The44patients were followed for12to30months (average16moths). According to The Majeed score of pelvic fractures postoperative functional, the outcomes were excellent in30cases, good in10cases, fair in4cases.2cases had fat liquefaction in incision while healed after changing dressing, eight case of deep vein thrombosis, cured by conservative treatment,3patients had suprapubic pain and discomfort in this group,1patients had pelvic tilt. No loosening or breaking of screws and no complication such as iatrogenic nerve or vascular injury, heterotypic ossification, osteoarthritis and a vascular disease happened at the follow-ups.Conclusion:Floating symphysis pubis is a kind of severe pelvic fracture it had affect on the stability of the pelvis. Open reduction and internal fixation is the way can obtaining good clinical results by stabilize the pelvis and also contribute in early functional rehabilitation.