The Pfannenstiel-approach – from 1900 until 2024

The Pfannenstiel approach is an often used approach while treating pelvic ring injuries. Especially, symphyseal plating is performed using this approach. The original description is based for performing gynecological transverse caesarean section. While originally, a transverse dissection of the rectus abdominis muscles were favored, the presently used dissection and exposure is completely different to the classical symphyseal approach. A clear trend is observed, based on the experience of pelvic surgeons to the so-called supra-symphyseal crosscut approach according to Küstner using a longitudinal fascial incision. A transverse fascial incision of the rectus sheaths is usually not performed. Thus, the term Pfannenstiel approach should be replaced by “modified Pfannenstiel approach”.

Level of evidence V