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Anterior ring fractures were classified based on a modified Nakatani classification as parasymphyseal (zone Ia), extra-symphyseal (zone Ib), zones II or III. Patient, fracture and implant characteristics were collected. The primary outcome was unplanned reoperation; secondary was radiographic loss of reduction. Comparisons were made across zones, with a sub-analysis restricted to LC1 injuries. Multivariable logistic regression was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 275 LC injuries (mean age 59.8\u2009\u00b1\u200921.3 years; 56% [n\u2009=\u2009155] female; reoperation rates were 6.5% (n\u2009=\u200918) overall and did not differ significantly across zones (Ia 12% [7\/60], Ib 5.7% [3\/53], II 6.8% [7\/103], III 1.7% [1\/59];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.2). Radiographic deformity differed significantly across zones (Ia 27% [16\/60], Ib 23% [12\/53], II 24% [25\/103], III 3.4% [2\/59];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), driven by the markedly lower rate in zone III. Multivariable regression confirmed deformity was associated with the low rate in zone III, while older age (OR 1.02 per year, 95% CI 1.00\u20131.04) and ramus comminution (OR 2.11, 95% CI 1.06\u20134.20) were independently associated with deformity. Reoperation did not differ by zone. When restricted to 183 LC1 injuries (mean age 64.1\u2009\u00b1\u200919.5 years; 61% [n\u2009=\u2009112] female), findings were similar.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Parasymphyseal fractures represent a challenging LC cohort. Loss of reduction is common but driven primarily by comminution and patient age rather than fracture location alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00590-026-04896-7","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T12:59:32Z","timestamp":1785761972000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Parasymphyseal fracture location in lateral compression pelvic ring injuries: an assessment of reoperation and radiographic displacement in an international multicenter study"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0608-3065","authenticated-orcid":false,"given":"Wayne","family":"Hoskins","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Gusho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rown","family":"Parola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Bravin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett","family":"Crist","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa","family":"Wenzel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime","family":"Bellamy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"Schweser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Della","family":"Rocca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josh","family":"Milby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Stannard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Haase","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"issue":"11","key":"4896_CR1","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1097\/BOT.0000000000002416","volume":"36","author":"NN O\u2019Hara","year":"2022","unstructured":"O\u2019Hara NN, Sim D, Moore D et al (2022) Prospective characterization of pain and function in patients with unstable pelvic fractures treated with posterior screw fixation. 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WH has given paid educational presentations for Smith & Nephew and Zimmer-Biomet, is an Associate Editor for Journal of Bone & Joint Surgery and Deputy Editor at European Journal of Orthopaedic Surgery & Traumatology; DB is a paid consultant for DePuy Synthes, Curvafix and Stryker; BC is a paid consultant for DePuy Synthes, 3M\/KCI, Osteocentric, Curvafix, Urgo Medical, Orthopediatrics, Invibio; receives royalties from Globus and Springer; is on the surgeon advisory board for Curvafix and 3M\/KCI; has stocks in Curvafix and RomTech; andreceives travel support from Arthrex.; JB has received funding from the Journal of Arthroplasty GDR has received research support from AAOS and AO Foundation; a consultant for Invibio (unpaid) and BioPoly (unpaid) and received royalties from Stryker.; KS is a paid consultant for Johnson and Johnson; has received grant funding from Arthrex and receives royalties from ODi. JPS is a paid consultant and receives research support from Arthrex, Inc; a paid consultant for DePuy, A Johnston & Johnston Company; on the editorial or governing board for Journal of Knee Surgery; receives researchsupport from National Institutes of Health (NIAMS & NICHD); a paid consultant for Orthopaedic Designs North America; a paid consultant for Smith & Nephew; receives publishing royalties, financial or material support from Thieme; receives research support for U.S. Department of Defense. DH is a paid consultant for DePuy Synthes and Arthrex. For each of the other authors, they certify that they have no commercial associations that might pose a conflict of interest in connection with the submitted article.","order":2,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"317"}}