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. 2022 Sep 21;5(4):e215.
doi: 10.1097/OI9.0000000000000215. eCollection 2022 Dec.

Percutaneous screw fixation of the pubic symphysis versus plate osteosynthesis: a biomechanical study

David E O'Neill  1 , Hallie R Bradley  1 , Brandon Hull  2 , William Pierce  3 , Ishvinder S Grewal  1 , Adam J Starr  1 , Ashoke Sathy  1
Affiliations

Percutaneous screw fixation of the pubic symphysis versus plate osteosynthesis: a biomechanical study

David E O'Neill et al. OTA Int. .

Abstract

Objectives: To compare the stability of screw fixation with that of plate fixation for symphyseal injuries in a vertically unstable pelvic injury (AO/Tile 61-C1) associated with complete disruption of the sacroiliac joint and the pubic symphysis. Methods: Eight fourth-generation composite pelvis models with sacroiliac and pubic symphyseal disruption (Sawbones, Vashon Island, WA) underwent biomechanical testing simulating static single-leg stance. Four were fixed anteriorly with a symphyseal screw, and 4 with a symphyseal plate. All had single transsacral screw fixation posteriorly. Displacement and rotation were monitored at both sacroiliac joint and pubic symphysis. Results: There was no significant difference between the 2 groups for mean maximum force generated. There was no significant difference in net displacement at both sacroiliac joint and pubic symphysis. There was significantly less rotation but more displacement in the screw group in the Z-axis. The screw group showed increased stiffness compared with the plate group. Conclusions: This is the first biomechanical study to compare screw versus plate symphyseal fixation in a Tile C model. Our biomechanical model using anterior and posterior fixation demonstrates that symphyseal screws may be a viable alternative to classically described symphyseal plating.

Keywords: Tile C; biomechanical; fixation; pelvic ring; pelvis; percutaneous; pubic symphysis; symphyseal fixation.

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Conflict of interest statement

The authors have no conflicts of interest.

Figures

Figure 1.
Figure 1.
A, AP projection of pelvis model with symphyseal plate and sacroiliac screw. B, AP projection of pelvis model with symphyseal screw and sacroiliac screw. C, Inlet projection of pelvis model with symphyseal screw and sacroiliac screw.
Figure 2.
Figure 2.
Pelvis model testing apparatus with Delrin sphere femoral head and turnbuckle used for abductor tensioning.
Figure 3.
Figure 3.
Schematic of axes of rotation and motion as measured.
Figure 4.
Figure 4.
A, Displacement in millimeters as measured using the testing apparatus. B, Rotation in degrees as measured using the testing apparatus.
Figure 5.
Figure 5.
A, Net displacement of the tested hemipelvis. B, Stiffness N/mm of the testing construct.
See this image and copyright information in PMC

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