Minimally Invasive Fixation of Osteoporotic Fractures With a Symphysis Plate (Syp)

Osteoporotic fractures are an increasing clinical problem. In the last 10 years the case load of Fragility Fractures oft he Pelvis (FFP) are dramaticaly increasing in incidence. In the elderly people a minimal invasive approach but also stable implant fixation in the osteoporotic bone is required to allow immediate mobilisation of the patients with full weight bearing. We developed a new implant fort he fixation oft he anterior pelvic ring. Actual anterior pelvic ring osteosynthesis in FFP fractures are treated depending on the distance to the symphysis with long canulated creep screws if the fracture is near to the Symphysis, with plates, which require larger trauma, or wit external fixators or subcutaneous fixators which are associated with a lot of soft tissue problems and other complicationes. Anatomical studies on 15 male and 15 female non fractured pelvis were analysed with the Im Fusion software to determin the range of angulation oft he upper pubis and the srew window ventro-medial to the acetabulum. The frontal and sagital angle range were determined (Man sagital 32 and frontal 43 degree and wooman 38 and 49 degree). The SYP consists of an anatomical plate with angle stable creep screw holes for the right and left pubis. Thise are canulated and allow cement augmentation. The central part oft he plate has on other 4 anteroposterior holes for angle stable fixation of symphysis fragments. The guide wires and screw insertion are placed with a special targeting device. To cover the range of anatomical angles fort he creep screws. Tthe principle oft he Poliaxnail targeting device is used. The sowbone and cadaver osteosynthesis studies showed a precise, fast and minimal invasive fixation. The Syp allows to combine features of all actual implants as minimal invasiveness of creep screw, fixation of the whole anterior ring like plates and angular stability like fixatores and due to the guideng device a minimal invasive simple and sure placement oft he screws.