The role of the bilateral subcutaneous plate in the minimal invasive stabilization of fragility fractures of the pelvis

Torsten Gerich; Ahmed Soliman; Jens Kelm; Stefan Maas

doi:10.1016/j.tcr.2022.100740

The role of the bilateral subcutaneous plate in the minimal invasive stabilization of fragility fractures of the pelvis

Trauma Case Rep. 2022 Nov 28:42:100740. doi: 10.1016/j.tcr.2022.100740. eCollection 2022 Dec.

Authors

Torsten Gerich¹, Ahmed Soliman², Jens Kelm³, Stefan Maas²

Affiliations

¹ Centre Hospitalier de Luxembourg, Service de Traumatologie, 4 rue Ernest Barblé, Luxembourg L-1210, Luxembourg.
² Department of Engineering, Campus Kirchberg, Université du Luxembourg, 6, rue Richard Coudenhove-Kalergi, Luxembourg L-1359, Luxembourg.
³ Chirurgisch-Orthopädisches Zentrum, Rathausstr 2, 66557 Illingen, Saar, Germany.

Abstract

Introduction: Anterior pelvic ring fractures are common in geriatric patients. Current treatment algorithms recommend osteosynthesis if no pain free mobilisation is possible. For this a multitude of surgical techniques have been described. Among these the Supraacetabular External Fixator (SEF) is regarded a simple and effective surgical procedure. However, this technique is associated with significant drawbacks.Alternatively, there is the option of an internal fixator or a formal plate osteosynthesis. It is the objective of this case report to present the Subcutaneous Iliopubic Plate (SIP) in a fragility fracture of the anterior and posterior pelvic ring.

Case report: An 83-year-old female patient sustained a fracture of the anterior pelvic ring, the lateral sacrum and the medial femoral neck. After initially refusing any surgery, the patient agreed to have the endoprosthesis implanted first, and then secondarily to dorsoventral osteosynthesis of the pelvis. Dorsally a transiliosacral screw osteosynthesis was performed. Anteriorly a bilateral subcutaneous iliopubic plate-osteosynthesis was chosen, a plate position that is anterior to the aponeurosis.

Conclusions: The subcutaneous plate has proven to be a quick and uncomplicated surgical procedure that is significantly better tolerated by patients than external stabilization.

Keywords: Anterior pelvic ring fracture; Biomechanics; Experimental test-bench; Pelvic fragility fracture; Pelvic stabilization.

Publication types

Case Reports