The Radiological and Functional Outcome for Trans-Symphyseal Cross-Screws in Superior Symphyseal Plate Fixation

Tile-type B1 “open book” external rotation injuries require stable fixation to restore function and prevent long-term complications. Superior symphyseal plate fixation is a commonly used technique, but concerns remain regarding its biomechanical stability. Open trans-symphyseal cross-screws have been proposed as an alternative or adjunct to improve fixation strength. This study evaluates the radiological and functional outcomes of open trans-symphyseal cross-screws in superior symphyseal plate fixation for pelvic ring injuries. A prospective analysis was conducted on 15 cases who underwent superior symphyseal plate fixation with additional trans-symphyseal cross-screws at Beni-Suef University Hospital between September 2021 and June 2023. Radiological outcomes were assessed using postoperative X-rays and CT scans to evaluate reduction quality, screw positioning, and potential complications like implant nonunion or failure. We measured the functional outcomes at 6–20 months postoperatively using the Majeed Pelvic Score, the Lowa Pelvic Score, and the Matta and Torentta criteria. A total of 15 patients were included. Radiological assessment showed satisfactory reduction in 52.5% of cases, with minimal loss of fixation over time. Functional assessment revealed a significant improvement in Majeed Pelvic Scores, with 60% achieving excellent or good outcomes at 12 months. Matt’s and Torentto’s scores indicated improved function according to the radiological outcomes at the last follow-up. Trans-symphyseal cross-screws provide a biomechanically stable construct with favorable radiological and functional outcomes. This technique may enhance fixation strength and improve postoperative recovery in patients with symphyseal disruptions.