At least one site of anterior arch disruption is almost always present, involving
- pubic symphysis disruption
- body fracture
- pubic ramus fracture
Their displacement and instability range from slight to extreme.
In general, pubic symphysis disruption, especially with significant displacement, should be treated with open reduction and internal fixation. Pubic ramus fractures, whose instability may be limited by soft tissue restraints may be treated with internal or external fixation. Their reduction may help reduce posterior arch displacement, and their fixation contributes to overall pelvic ring stability.