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01.12.2017 | Research article | Ausgabe 1/2017 Open Access

BMC Musculoskeletal Disorders 1/2017

Is there a clinical benefit of additional tension band wiring in plate fixation of the symphysis?

Zeitschrift:
BMC Musculoskeletal Disorders > Ausgabe 1/2017
Autoren:
Myung-sik Park, Sun-Jung Yoon, Seung-min Choi, Kwanghun Lee

Abstract

Background

The purpose of this study was to determine whether additional tension band wiring in the plate for traumatic disruption of symphysis pubis has clinical benefits. Therefore, outcomes and complications were compared between a plate fixation group and a plate with tension band wiring group.

Methods

We retrospectively evaluated 64 consecutive patients who underwent open reduction and internal fixation of the symphysis pubis by using a plate alone (n = 39) or a plate with tension band wiring (n = 25). All the patients were followed up for a minimum of 24 months (mean, 34.4 months; range, 26–39 months). Demographic characteristics, outcomes, movement of the metal works, complications, revision surgery, and Majeed functional score were compared.

Results

Significant screw pullout was relatively significantly more frequently found in the plate fixation group than in the plate with tension band wiring group (P = 0.009). In terms of the overall rate of all-cause revision surgery, including significant loosening, symptomatic hardware, and patient-requested hardware removal during follow-up period, the plate with tension band wiring group showed a significantly lower rate.

Conclusion

Tension band wiring in combination with a symphyseal plate showed better radiological outcomes, a lower incidence of hardware loosening, and a lower rate of revision surgery than plate fixation alone. This technique would have some potential advantages in terms of avoiding significant movement of plate, symptomatic hardware failure, and revision surgery.
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