{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T13:55:57Z","timestamp":1774533357141,"version":"3.50.1"},"reference-count":36,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Col. Bras. Cir."],"abstract":"<jats:p>ABSTRACT Purpose: although locking plates have led to important changes in fracture management, becoming important tools in the orthopedic surgeon\u2019s arsenal, the benefits of locking plates for traumatic diastasis of the pubic symphysis have not been established. This study was conducted to assess the quality of life in its different domains among patients with traumatic diastasis of the pubic symphysis managed either with locking or nonlocking plate. Methods: a prospective cohort study was undertaken at 3 level 1 trauma centres in Brazil. Patients presenting traumatic diastasis of the pubic symphysis treated with plate fixation with a minimum follow-up of 12 months were eligible for inclusion. Through a Pfannenstiel approach, the pubic symphysis was reduced and fixed with a superiorly positioned 4.5mm four to six hole reconstruction locked plate or 3.5mm four to six hole reconstruction nonlocked plate. Posterior injury was managed during the same procedure. Outcome measures were adequate healing of the pelvic injuries, return to pre-injury level on daily activities, and quality of life at the last follow-up visit. Complications and modes of failure were summarized and reviewed. Bivariate linear regression was used to assess individual factors affecting patients\u2019 health-related quality of life. A p value of &lt;5% was considered significant. Results: a total of 31 adult patients (29 males and 2 females) were eligible for the study. Thirteen patients were managed with a reconstruction locked plate and 18 patients with a nonlocked reconstruction plate. Average postoperative follow-up time was 24 months. Adequate healing of the pelvic injuries was achieved in 61.5% of patients treated with locking plates and 94.4% of patients treated with nonlocking plates (p=0.003). Radiographic failure of fixation with minor complications occurred in 46.1% of patients after locked plating versus 11.1% of patients in the nonlocking plate group (p=0.0003). In bivariate analysis, abnormal gait (p=0.007) was associated with a reduced long-term quality of life as measured with the EQ-5D-3L. Conclusion: internal fixation of traumatic diastasis of the pubic symphysis with locking plates has no clinical advantage when compared to nonlocked plating. Mechanical failure and inadequate healing are significantly increased after locked plating of the pubic symphysis. Therefore, we do not recommend routine use of locking plates for managing patients presenting traumatic diastasis of the pubic symphysis. Level of evidence: II (prospective, cohort study).<\/jats:p>","DOI":"10.1590\/0100-6991e-20213122","type":"journal-article","created":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T12:08:13Z","timestamp":1640002093000},"source":"Crossref","is-referenced-by-count":1,"title":["No clinical advantage of locking over nonlocking plate fixation of symphyseal disruptions"],"prefix":"10.1590","volume":"48","author":[{"given":"CHRISTIANO SALIBA","family":"ULIANA","sequence":"first","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"EIJI RAFAEL","family":"NAKAHASHI","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"LUIZ HENRIQUE PENTEADO","family":"SILVA","sequence":"additional","affiliation":[{"name":"Instituto de Ortopedia e Traumatologia, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ANDERSON","family":"FREITAS","sequence":"additional","affiliation":[{"name":"Instituto de Pesquisa e Ensino, Brazil; Hospital Regional do Gama, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4429-312X","authenticated-orcid":false,"given":"VINCENZO","family":"GIORDANO","sequence":"additional","affiliation":[{"name":"Hospital Municipal Miguel Couto, Brasil; Rede D\u2019or S\u00e3o Luiz, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","published-online":{"date-parts":[[2021]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"S56","DOI":"10.1016\/S0020-1383(18)30305-X","article-title":"Why and how do locking plates fail","volume":"49","author":"Gueorguiev 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J"},{"issue":"3","key":"ref34","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1302\/0301-620X.87B3.15662","article-title":"Erectile dysfunction after fracture of the pelvis","volume":"87","author":"Harwood PJ","year":"2005","journal-title":"J Bone Joint Surg Br"},{"issue":"5","key":"ref35","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1111\/j.1471-0528.2004.00120.x","article-title":"Pelvic floor dysfunction in women after pelvic trauma","volume":"111","author":"Baessler K","year":"2004","journal-title":"BJOG"},{"issue":"2","key":"ref36","first-page":"122","article-title":"Neurological damage in pelvic injuries a continuous prospective series of 50 pelvic injuries treated with an iliosacral lag screw","volume":"90","author":"Tonetti J","year":"2004","journal-title":"Rev Chir Orthop Reparatrice Appar Mot"}],"container-title":["Revista do Col\u00e9gio Brasileiro de Cirurgi\u00f5es"],"original-title":[],"deposited":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T14:50:39Z","timestamp":1699973439000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0100-69912021000100237&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021]]},"references-count":36,"alternative-id":["S0100-69912021000100237"],"URL":"https:\/\/doi.org\/10.1590\/0100-6991e-20213122","relation":{},"ISSN":["1809-4546","0100-6991"],"issn-type":[{"value":"1809-4546","type":"electronic"},{"value":"0100-6991","type":"print"}],"subject":[],"published":{"date-parts":[[2021]]},"article-number":"e20213122"}}