Gänsslen Axel, Lindahl Jan, Krappinger Dietmar, Lindtner Richard A, Staresinic Mario
Hannover Medical School, Hanover, Germany.
Johannes Wesling Klinikum Minden, Minden, Germany.
Arch Orthop Trauma Surg. 2025 May 21;145(1):306. doi: 10.1007/s00402-025-05904-x.
Detection of disruption of the pubic symphysis and resulting anterior pelvic ring instability primarily depends on the symphyseal widening on standard anterior-posterior X-rays. Based on biomechanical and clinical analyses from the 80 to 90's, a cut-off value of 2.5 cm widening distinguished between stable and unstable lesions. A relevant debate developed concerning minor (< 2.5 cm displacement), moderate (> 2.5 cm displacement) and severe disruptions (> 2.5 cm displacement + posterior complete pelvic ring instability) of the pubic symphysis. Analysis of anatomic, biomechanical, physiological and clinical literature showed, that an exact value does not allow this differentiation. Thus, symphyseal posttraumatic disruptions with displacements > 10 mm should be treated surgically, while in minor displacements (5-10 mm) stress examination can guide adequate treatment.
耻骨联合分离及由此导致的骨盆前环不稳定的检测主要依赖于标准前后位X线片上耻骨联合的增宽情况。基于20世纪80至90年代的生物力学和临床分析，2.5厘米的增宽截断值可区分稳定和不稳定损伤。关于耻骨联合的轻度（<2.5厘米移位）、中度（>2.5厘米移位）和重度损伤（>2.5厘米移位+骨盆后环完全不稳定）展开了一场相关辩论。对解剖学、生物力学、生理学和临床文献的分析表明，一个确切的值无法进行这种区分。因此，移位>10毫米的创伤后耻骨联合分离应进行手术治疗，而对于轻度移位（5-10毫米），应力检查可指导适当的治疗。
