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The clinical relevance of fixation failure after pubic symphysis plating for anterior pelvic ring injuries: an observational cohort study with long-term follow-up.
- Source :
-
Patient Safety in Surgery . 5/22/2024, Vol. 18 Issue 1, p1-7. 7p. - Publication Year :
- 2024
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Abstract
- Background: Open reduction and plate fixation is a standard procedure for treating traumatic symphyseal disruptions, but has a high incidence of implant failure. Several studies have attempted to identify predictors for implant failure and discussed its impact on functional outcome presenting conflicting results. Therefore, this study aimed to identify predictors of implant failure and to investigate the impact of implant failure on pain and functional outcome. Methods: In a single-center, retrospective, observational non-controlled cohort study in a level-1 trauma center from January 1, 2006, to December 31, 2017, 42 patients with a plate fixation of a traumatic symphyseal disruption aged ≥ 18 years with a minimum follow-up of 12 months were included. The following parameters were examined in terms of effect on occurrence of implant failure: age, body mass index (BMI), injury severity score (ISS), polytrauma, time to definitive treatment, postoperative weight-bearing, the occurrence of a surgical site infection, fracture severity, type of posterior injury, anterior and posterior fixation. A total of 25/42 patients consented to attend the follow- up examination, where pain was assessed using the Numerical Rating Scale and functional outcome using the Majeed Pelvic Score. Results: Sixteen patients had an anterior implant failure (16/42; 37%). None of the parameters studied were predictive for implant failure. The median follow-up time was six years and 8/25 patients had implant failure. There was no difference in the Numerical Rating Scale, but the work-adjusted Majeed Pelvic Score showed a better outcome for patients with implant failure. Conclusion: implant failure after symphyseal disruptions is not predictable, but appears to be clinically irrelevant. Therefore, an additional sacroiliac screw to prevent implant failure should be critically discussed and plate removal should be avoided in asymptomatic patients. [ABSTRACT FROM AUTHOR]
- Subjects :
- *RISK assessment
*WOUNDS & injuries
*WEIGHT-bearing (Orthopedics)
*PELVIC bones
*COMPLICATIONS of prosthesis
*THERAPEUTICS
*BODY mass index
*T-test (Statistics)
*FRACTURE fixation
*SCIENTIFIC observation
*ORTHOPEDIC implants
*FUNCTIONAL status
*RETROSPECTIVE studies
*SEVERITY of illness index
*DESCRIPTIVE statistics
*MANN Whitney U Test
*LONGITUDINAL method
*TRAUMA centers
*PELVIC fractures
*PAIN
*TREATMENT failure
*PUBIC symphysis
*POSTOPERATIVE period
*SURGICAL site infections
*DATA analysis software
*DISEASE risk factors
Subjects
Details
- Language :
- English
- ISSN :
- 17549493
- Volume :
- 18
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Patient Safety in Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 177422761
- Full Text :
- https://doi.org/10.1186/s13037-024-00401-3