A pelvic fracture model for the assessment of treatment options in a laboratory environment☆

Summary 

Background

Optimal prehospital and clinical management of patients with severe pelvic trauma is controversial. Prospective evaluations of different treatment strategies have not been performed and treatment is currently not evidence-based. The purpose of the present study was to develop a porcine model of reproducible severe pelvic trauma for subsequent laboratory trials.

Methods

The study was performed on 13 juvenile porcine cadavers. Pelvic fractures were created by applying a pure anterior–posterior compression load to the pelvic ring using a servohydraulic material testing machine. Fracture patterns were classified according to the Young–Burgess classification and the Tile classification using postfracture CT scans including 3D-reconstructions.

Results

Disruptions of the posterior pelvic ring segment were unilateral in 12 cases and bilateral in one case transforaminal vertical sacrum fractures. Injuries of the anterior ring segment were obturator ring fractures bilateral, ipsilateral or contralateral to the injury of the posterior ring segment. According to the Tile classification this resulted in 12 type C1 and 1 type C3 fractures. In the Young classification all injuries were classified as type APC III. In six cases transverse process fractures were found ipsilateral to the posterior ring disruption. Initial force drops indicating bony or ligamentous injuries occurred at mean forces of 4030±269N (range, 3617–4374N).

Conclusion

The present model was able to create reproducible unstable pelvic fractures and can be used for controlled laboratory trials to study the management of patients with pelvic fractures.

Keywords: Pelvic fracture, Porcine model, Hemorrhagic shock, Angiography