Retrospective Evaluation of Pelvic and Acetabular Fracture Fixation Using the Stryker PRO Pelvis Next Generation Plating System

TL;DR

This study evaluates the effectiveness of the Stryker PRO plating system for treating pelvic and acetabular fractures, finding it comparable to existing methods in terms of healing and complications.

Contribution

The study provides a retrospective clinical evaluation of a next-generation plating system for complex pelvic and acetabular fractures.

Findings

Radiographic and clinical consolidation were achieved in 80% of cases each, with 95% overall union.

Adverse events occurred in 25% of patients, with 16.6% requiring reoperation.

The system's outcomes were comparable to current literature on pelvic and acetabular fracture fixation.

Abstract

Introduction

Acetabular and pelvic fractures account for roughly 3% of all skeletal injuries and typically result from high-energy trauma. Surgical fixation is often required to restore pelvic stability and joint congruency. These procedures are technically demanding due to complex pelvic anatomy and limited access. Reconstruction plates are commonly used for their versatility in compression, tension, buttress, and antiglide functions.

The Stryker Pelvic PRO Next Generation plating system (Stryker, Portage, MI) offers implants for anterior and posterior fixation, designed to accommodate complex bony morphology. This study evaluates clinical and radiographic outcomes in patients treated with this implant system. We hypothesized that its use would yield rates of bone consolidation, nonunion, and adverse events comparable to the current literature.

Methods

With institutional review board approval, a retrospective review was conducted at a level I trauma center for patients treated with the Stryker PRO system between January and October 2024. Cases were identified using Current Procedural Terminology codes 27226, 27227, and 27228. Demographics, injury characteristics, surgical details, and outcomes were collected. Radiographic bone consolidation was defined as the presence of bridging callus in three out of four cortices with no visible fracture line or the disappearance of fracture lines, while clinical consolidation was defined as the patient achieving full weight-bearing status without pain. Delayed union was defined as the absence of radiographic healing by three months post-operatively, while nonunion was defined as persistent fracture at six months requiring surgical intervention or documented pain with visible fracture line. Descriptive statistics were performed using IBM SPSS Version 29.0.2.0.

Results

The study included 20 patients (mean age 44.6, 70% male) with pelvic or acetabular fractures. Most injuries resulted from motor vehicle accidents (70%), with common fracture types including AO 62.A1/62.B1 and posterior wall fractures. Radiographic and clinical consolidation were achieved in 80% of cases each, with 95% overall union. Seven adverse events occurred in five (25%) patients, including infection, heterotopic ossification, osteolysis, and avascular necrosis; 16.6% required reoperation. A total of 28 plates were used, most commonly spring plates (50%); 70% of patients required additional fixation.

Conclusion

The Stryker PRO implant system demonstrated rates of bone consolidation, nonunion, and adverse events comparable to the current literature.

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