Objective:

To compare the outcomes of infix versus percutaneous anterior retrograde pubic ramus screw fixation in the management of unilateral zone II and III pubic ramus fractures in unstable pelvic injuries.

Approach:

• Study Design: A prospective randomized cohort study conducted from August 2023 to August 2025 at a university hospital.
• Participants: Fifty patients with anterior ring injuries were enrolled and randomly allocated into two groups: group 1 underwent anterior infix fixation, while group 2 received percutaneous retrograde pubic ramus screw fixation.
• Assessment Methods: Primary evaluation was based on the Pelvic Outcome Score, with secondary assessments including intra-operative parameters, radiological outcomes using the Matta score, and functional outcomes using the Majeed score.

Key Findings:

• Anterior pelvic ring fractures account for approximately 3% of adult fractures and can lead to significant morbidity and mortality.
• The Infix technique is minimally invasive and effective for managing complex anterior pelvic ring injuries, providing satisfactory reduction, favorable radiological and functional outcomes, and reliable fracture healing.
• Percutaneous retrograde pubic ramus screw fixation offers minimal blood loss and lower rates of complications but is technically demanding.

Interpretation:

Both fixation techniques are viable options for stabilizing anterior pelvic ring injuries, with specific advantages and challenges associated with each method.

Limitations:

• The study was conducted at a single center, which may limit generalizability.
• Sample size was calculated based on previous data, which may not reflect current clinical outcomes.

Conclusion:

The study aims to provide comparative insights into the effectiveness of two minimally invasive techniques for anterior pelvic ring injuries.