The role of the bilateral subcutaneous plate in the minimal invasive stabilization of fragility fractures of the pelvis

Introduction: Anterior pelvic ring fractures are common in geriatric patients. Current treatment
algorithms recommend osteosynthesis if no pain free mobilisation is possible. For this a multitude
of surgical techniques have been described. Among these the Supraacetabular External Fixator
(SEF) is regarded a simple and effective surgical procedure. However, this technique is associated
with significant drawbacks.
Alternatively, there is the option of an internal fixator or a formal plate osteosynthesis. It is the
objective of this case report to present the Subcutaneous Iliopubic Plate (SIP) in a fragility
fracture of the anterior and posterior pelvic ring.
Case report: An 83-year-old female patient sustained a fracture of the anterior pelvic ring, the
lateral sacrum and the medial femoral neck. After initially refusing any surgery, the patient
agreed to have the endoprosthesis implanted first, and then secondarily to dorsoventral osteosynthesis
of the pelvis. Dorsally a transiliosacral screw osteosynthesis was performed. Anteriorly a
bilateral subcutaneous iliopubic plate-osteosynthesis was chosen, a plate position that is anterior
to the aponeurosis.
Conclusions: The subcutaneous plate has proven to be a quick and uncomplicated surgical procedure
that is significantly better tolerated by patients than external stabilization.