{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:40:20Z","timestamp":1756305620839,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,7,7]]},"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:p>We are describing a case report of a morbidly obese patient (body mass index 41) in his mid-40s with Young and Burgess Anteroposterior Compression type II injury (AO Foundation\/Orthopaedic Trauma Association type B1.2) managed by symphyseal plating. Morbid obesity made working at a depth very difficult; hence, we adopted a novel \u2018wire-ramp plate-sliding method\u2019. In this method, two strong sturdy K-wires inserted through the medial-most plate holes into the pubis acted as a ramp over which the plate was pushed\/slid distally. During this manoeuvre, the K-wires passing through the plate holes were used as a reduction tool. The patient also had a wedge fracture of the distal femoral shaft which was managed by retrograde femoral nailing. At 1-year follow-up, the pelvic continuity is maintained and the fracture has united. The patient is able to do full weight-bearing and is back to his normal life.<\/jats:p>","DOI":"10.1136\/bcr-2022-254279","type":"journal-article","created":{"date-parts":[[2023,7,21]],"date-time":"2023-07-21T13:25:23Z","timestamp":1689945923000},"page":"e254279","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Symphyseal plating for pelvic fracture in a morbidly obese patient: operative challenges and innovation of a novel \u2018wire-ramp plate-sliding method\u2019"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2164-0029","authenticated-orcid":false,"given":"Kumar","family":"Keshav","sequence":"first","affiliation":[{"name":"Orthopaedics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manjunath","family":"Nishani","sequence":"additional","affiliation":[{"name":"Orthopaedics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2094-2930","authenticated-orcid":false,"given":"Amarendra","family":"Singh","sequence":"additional","affiliation":[{"name":"Orthopaedics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abhishek","family":"Singh","sequence":"additional","affiliation":[{"name":"Orthopaedics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,7,21]]},"reference":[{"key":"2025082707122775000_16.7.e254279.1","doi-asserted-by":"publisher","DOI":"10.1016\/0020-1383(95)92180-I"},{"key":"2025082707122775000_16.7.e254279.2","doi-asserted-by":"crossref","first-page":"2154","DOI":"10.1007\/s11999-012-2427-z","article-title":"Is fixation failure after plate fixation of the Symphysis Pubis clinically important","volume":"470","author":"Morris","year":"2012","journal-title":"Clin Orthop Relat Res"},{"key":"2025082707122775000_16.7.e254279.3","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.00885"},{"key":"2025082707122775000_16.7.e254279.4","doi-asserted-by":"crossref","first-page":"1965","DOI":"10.1007\/s00402-022-04411-7","article-title":"The radiographic outcome after Plating for Pubic Symphysis Diastasis: does it matter clinically? arch Orthop trauma Surg published online first","volume":"143","author":"Tseng","year":"2022","journal-title":"Arch Orthop Trauma Surg"},{"key":"2025082707122775000_16.7.e254279.5","doi-asserted-by":"crossref","DOI":"10.1186\/s13037-018-0172-2","article-title":"Complications of pelvic and Acetabular fractures in 1331 Morbidly obese patients (BMI\u2009\u2265\u200940): a retrospective observational study from the National trauma data bank","volume":"12","author":"Carson","year":"2018","journal-title":"Patient Saf Surg"},{"key":"2025082707122775000_16.7.e254279.6","doi-asserted-by":"crossref","DOI":"10.2106\/JBJS.CC.18.00075","article-title":"Stabilization of a type B1.1 injury in a Morbidly obese patient using an internal Fixator in a minimally invasive technique: A case report","volume":"9","author":"Fritz","year":"2019","journal-title":"JBJS Case Connect"},{"key":"2025082707122775000_16.7.e254279.7","doi-asserted-by":"crossref","unstructured":"Baldini-Garcia L , Altamirano-Cruz MA . n.d. 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Trans-Obturator Cable fixation of open book pelvic injuries. 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