Single vs Double Symphyseal Plating in Management of Vertically Unstable Open Book Pelvic Ring Injuries:
- Conditions
- Evaluation of Single Symphyseal Plating in APC III Injuries
- Interventions
- Procedure: single symphyseal plating in management of vertically unsable open book pelvic ring injuries
- Registration Number
- NCT06439108
- Lead Sponsor
- Ain Shams University
- Brief Summary
compare functional, radiological outcomes, implant failure and the incidence of recurrent diastasis of single superior symphyseal plate versus double plating in management of vertically unstable open book injuries
- Detailed Description
The real algorithm was the necessity for double superior \& anterior plating versus single superior symphyseal plate in management of APC III pelvic ring injuries, whether the incidence of intraoperative and short-term postoperative complications, recurrent diastasis, radiological and functional outcomes differed between these two methods. Our hypothesis was that the use of an additional anterior symphyseal plating could provide a more rigid fixation, with less complications of recurrent diastasis or implant failure. Also it will be applied through the same incision without increasing the patient overall morbidity.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 30
- Anterior ring symphyses diastasis
- Tile C pelvic ring injuries
- Age between 16-60 years' old
- Tile B pelvic ring injuries
- Isolated bony fractures of the anterior pelvic ring
- Open fractures
- Age less than 14 years and older than 60 years
- Associated internal organ injuries that require definitive intervention
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description double superior & anterior symphyseal plates single symphyseal plating in management of vertically unsable open book pelvic ring injuries 15 cases undergoing double superior \& anterior symphyseal plates, 15 cases undergoing double superior \& anterior symphyseal plates, reduction of the posterior ring was either closed reduction in SI joint dislocations \& fracture-dislocations and sacral fractures or open reduction in iliac wing fractures through the lateral window of the ilioinguinal approach.Anterior pelvic ring reduction and fixation was done via the classic Pfannenstiel approach single superior symphyseal plate single symphyseal plating in management of vertically unsable open book pelvic ring injuries 15 cases undergoing single superior symphyseal plate, reduction of the posterior ring was either closed reduction in SI joint dislocations \& fracture-dislocations and sacral fractures or open reduction in iliac wing fractures through the lateral window of the ilioinguinal approach.Anterior pelvic ring reduction and fixation was done via the classic Pfannenstiel approach
- Primary Outcome Measures
Name Time Method Rate of recurrent diastasis throughout study completion, average one year postoperative rate of symphyseal translation was measured \& compared between the two study groups
Rate of Excellent, Good, Fair or Poor clinical outcome 1 year postoperative clinical assessment by Majeed pelvic scoring system evaluated and calculated at each follow-up visit with the mean value presented
Rate of Excellent, Good, Fair or Poor radiological outcome 1 year postoperative Radiological assessment using Matta \& Tornetta radiological principles via plain x-ray pelvis showing both hips: anteroposterior, inlet and outlet views \& CT pelvis if available; we evaluated five criteria on X-ray films postoperatively: residual posterior displacement, vertical displacement, pubic symphyseal translation, sagittal rotation, and gapping of the sacroiliac joint; according to the grading of Matta and Tornetta, we classified the results into Excellent (less than or equal 4 mm), Good (4-10 mm), Fair (10-20 mm), and Poor (more than 20 mm).
- Secondary Outcome Measures
Name Time Method Mean intraoperative blood loss up to 5 days post-operative The mean blood loss was calculated in milliliters and compared between the two study groups, it was measured intraoperative and postoperative from suction drains
Mean operative time It was calculated intra-operative The mean operation time was calculated in minutes and compared between the two study groups
postoperative complications' rate 1 year post-operative We focused the evaluation of Postoperative complications on the local complications related to fixation principles and technique: LLD, implant failure, wound infection, residual malunion or non-union of the anterior ring, and loss of reduction (2ry SI dislocation or any rotational or vertical re-displacement)
Trial Locations
- Locations (1)
Islam Sayed Moussa
🇪🇬Cairo, Abassia, Egypt