Bridging Plate Osteosynthesis

Abstract

Posterior bridging plate osteosynthesis is an established stabilization technique for high-energy posterior pelvic ring disruptions. A reconstruction plate is placed posterior to the sacrum between the posterior superior iliac spines and bent around the posterior iliac crests. The plate can also be placed in the notch just inferior to the posterior inferior iliac spines. Long screws are inserted through the marginal plate holes on each side. An angular-stable plate may also be used in the same position. It is of major importance to place the plate below the fascia. A comparative biomechanical study demonstrated that the strength of the transiliac plate fixation was equal to that of transiliac sacral bar fixation with one or two bars. A transiliac locked compression plate can be used in mono- or bilateral sacral insufficiency fractures or impending insufficiency fractures with severe dorsal pain. In an 8-year period, we treated 55 patients with a fragility fracture of the sacrum with a posterior bridging locked compression plate. There were no neurovascular complications. There was one deep wound infection. All other patients could be mobilized with pain-adapted weight-bearing immediately after surgery. Posterior angular stable bridging plate osteosynthesis is a simple, safe, quick and reliable stabilization technique for patients with fragility fractures of the pelvis.