Case Overview

This video discusses the novel technique of using a dynamic fixation construct with suture buttons for the definitive management of anterior pelvic ring injuries characterized by pubic symphysis diastasis (open book pelvis). The technique requires only four suture buttons with two strands and a suture passer/retriever device. The pubic symphysis is stabilized by the construct in the anterior-posterior and superior-inferior planes.

Method/Technique

A dynamic fixation construct (rather than rigid plate fixation) of the anterior pelvis is demonstrated for the management of anteroposterior compression type II and type III injuries. The technical pearls and potential pitfalls are discussed.

Results In a small case series, patients with a traumatic presentation have reported favorable outcomes. Historical results and outcomes in the literature are presented and discussed.

Summary

This video presents the technique of dynamic suture button fixation for the management of the open book pelvis. Indications, contraindications, technical considerations, and outcomes are discussed. The quantity and quality of evidence for other applications of dynamic suture button fixation recently have been evolving, and the pubic symphysis is a promising alternative for exploration.