Abstract
Despite the remarkable advances achieved within the boundaries of the new discipline
of Pelvic surgery, pelvic ring disruptions remain challenging and complex problems
in orthopaedics. The long-term complications related to reconstruction techniques
of these injuries have motivated researchers and surgeons to explore various alternative
treatment modalities. Several biomechanical studies have addressed these issues. We
performed a medline search including studies published during the last 30 years. Our
search yielded 114 studies, 39 of which met the pre-specified inclusion criteria and
were further critically analysed and discussed regarding the biomechanical aspects
of pelvic ring reconstruction techniques. Based on observational approach and evaluation
of the studies specific keypoints are highlighted comprising the clinical translation
of the biomechanical supported findings.
Keywords
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References
- Posterior pelvic fixation using a transiliac 4.5-mm reconstruction plate: a clinical and biomechanical study.J Orthop Trauma. 1993; 7: 226-232
- External fixation of unstable pelvic ring fractures: comparative rigidity of some current frame configurations.Med Biol Eng Comput. 1982; 20: 727-733
- Laparotomy and unstable pelvic fractures.Injury. 2008; 39: 853-857
- Differences of percutaneous retrograde screw fixation of anterior column acetabular fractures between male and female: a study of 164 virtual three-dimensional models.Injury. 2009; 40: 1067-1072
- Biomechanical comparison of posterior internal fixation techniques for unstable pelvic fractures.J Orthop Trauma. 1996; 10: 517-522
- A study of external skeletal fixation systems for unstable pelvic fractures.J Trauma. 1984; 24: 876-881
- Biomechanical studies of an anterior pelvic external fixation frame intended for control of vertical shear fractures.South Med J. 1986; 79: 815-817
- Use of the trauma pelvic orthotic device (T-POD) for provisional stabilisation of anterior–posterior compression type pelvic fractures: a cadaveric study.Injury. 2008; 39: 903-906
- Experimental study of the sacroiliac joint micromotion in pelvic disruption.J Orthop Trauma. 2002; 16: 99-103
- Pelvic fractures due to falls from a height in people with mental disorders.Injury. 2008; 39: 881-888
- Definitive control of mortality from severe pelvic fracture.Ann Surg. 1990; 211 ([discussion 6–7]): 703-706
- Three-dimensional finite element analysis of several internal and external pelvis fixations.J Biomech Eng. 2000; 122: 516-522
- Sacroiliac joint compression using an anterior pelvic compressor: a mechanical study in synthetic bone.J Orthop Trauma. 2007; 21: 435-441
- Emergent treatment of pelvic fractures. Comparison of methods for stabilization.Clin Orthop Relat Res. 1995; : 75-80
- The effect of laparotomy and external fixator stabilization on pelvic volume in an unstable pelvic injury.J Trauma. 1995; 38 ([discussion 1]): 396-400
- Advances in pelvic and acetabular surgery.Injury. 2007; 38: 395-396
- Operative treatment of displaced fractures of the acetabulum. A meta-analysis.J Bone Joint Surg Br. 2005; 87: 2-9
- Surgical techniques-How do I do it? Open reduction and internal fixation of posterior wall fractures of the acetabulum.Injury. 2008; 39: 1113-1118
- Is the lateral sacral fluoroscopic view essential for accurate percutaneous sacroiliac screw insertion? An experimental study.Injury. 2008; 39: 875-880
- Pelvic and acetabular surgery within Europe: the need for the co-ordination of treatment concepts.Injury. 2007; 38: 410-415
- Two-level reconstruction of comminuted posterior-wall fractures of the acetabulum.J Bone Joint Surg Br. 2007; 89: 503-509
- Percutaneous fixation of the pelvic ring: an update.J Bone Joint Surg Br. 2007; 89: 145-154
- The strength of iliosacral lag screws and transiliac bars in the fixation of vertically unstable pelvic injuries with sacral fractures.Injury. 1996; 27: 561-564
- Open pelvic fractures: epidemiology, current concepts of management and outcome.Injury. 2005; 36: 1-13
- Fixation of pelvic fractures and dislocations. An experimental study on the loading of pelvic fractures and sacro-iliac dislocations after external compression fixation.Acta Orthop Scand. 1978; 49: 278-286
- Perineal hygiene in patients with pelvic fractures.Injury. 2008; 39: 889-892
- Pelvic ring fractures internal fixation: iliosacral screws versus sacroiliac hinge fixation.Orthop Traumatol Surg Res. 2009; 95: 563-567
- fractures of the acetabulum: classification and surgical approaches for open reduction. preliminary report.J Bone Joint Surg Am. 1964; 46: 1615-1646
- The role of external fixation in pelvic disruptions.Clin Orthop Relat Res. 1989; : 66-82
- Biomechanical testing of a novel four-rod technique for lumbo-pelvic reconstruction.Spine (Phila Pa 1976). 2008; 33: E400-E406
- Translational research: from benchside to bedside.Injury. 2008; 39: 643-650
- Lateral compression fracture of the pelvis represents a heterogeneous group of complex 3D patterns of displacement.Injury. 2008; 39: 893-902
- Effect of pin location on stability of pelvic external fixation.Clin Orthop Relat Res. 1999; : 237-244
- Biomechanical testing of new and old fixation devices for vertical shear fractures of the pelvis.J Orthop Trauma. 1991; 5: 313-317
- Pelvic fractures.Injury. 1978; 10: 145-148
- Management of traumatic sacral fractures: a retrospective case-series study and review of the literature.Injury. 2010; 41: 266-272
- Stability of open-book pelvic fractures using a new biomechanical model of single-limb stance.J Orthop Trauma. 1997; 11: 590-593
- Long-term outcome in patients with combined spinal and pelvic fractures.Injury. 2007; 38: 598-606
- Internal fixation of unstable pelvic ring injuries.Clin Orthop Relat Res. 1996; : 129-140
- Innovations in osteosynthesis and fracture care.Injury. 2008; 39: 827-838
- Biomechanical comparison of three methods of sacral fracture fixation in osteoporotic bone.Spine (Phila Pa 1976). 2010; 35: E392-E395
- Percutaneous transiliac pelvic fracture fixation: cadaver feasibility study and preliminary clinical results.J Trauma. 2007; 62 ([discussion 64]): 357-364
- A computational study of the magnitude and direction of migration forces in patient-specific abdominal aortic aneurysm stent-grafts.Eur J Vasc Endovasc Surg. 2010; 40: 332-339
- Hemorrhage associated with major pelvic fracture: a multispecialty challenge.J Trauma. 1986; 26: 987-994
- It's not all about birth: biomechanics applied to pelvic organ prolapse prevention.J Midwifery Womens Health. 2008; 53: 28-36
- Assessment of pelvic ring stability after injury. Indications for surgical stabilization.Clin Orthop Relat Res. 1996; : 15-27
- Direct retroperitoneal pelvic packing versus pelvic angiography: a comparison of two management protocols for haemodynamically unstable pelvic fractures.Injury. 2009; 40: 54-60
- Multiple trauma: an ongoing evolution of treatment modalities?.Injury. 2009; 40: 115-119
- Biomechanics of pelvic ring and its structural elements.Vestn Ross Akad Med Nauk. 2008; : 44-47
- Fixation of transforaminal sacrum fractures: a biomechanical study.J Orthop Trauma. 1993; 7: 107-117
- External fixators for pelvic fractures: comparison of the stiffness of current systems.Acta Orthop Scand. 2003; 74: 165-171
- External fixation of the pelvic ring: an experimental study on the role of pin diameter, pin position, and parasymphyseal fixator pins.Acta Orthop. 2007; 78: 648-653
- Improvement of external fixator performance in type C pelvic ring injuries by plating of the pubic symphysis: an experimental study on 12 external fixators.J Trauma. 2002; 53 ([discussion 12–3]): 907-912
- Anterior versus posterior pin placement of pelvic C-clamp in relationship to anatomical structures: a cadaver study.Injury. 2008; 39: 865-868
- Clinical and biomechanical aspects of external fixation of the pelvis.Clin Biomech (Bristol, Avon). 1996; 11: 322-327
- Comparative mechanical performances of some new devices for fixation of unstable pelvic ring fractures.Med Biol Eng Comput. 1983; 21: 657-663
- Biomechanical analysis of fixation for vertically unstable sacroiliac dislocations with iliosacral screws and symphyseal plating.J Orthop Trauma. 2004; 18: 138-143
- An unusual type of lateral compression injury of the pelvis tilt fracture with anterior displacement.Injury. 2009; 40: 1036-1039
- Triangular osteosynthesis and iliosacral screw fixation for unstable sacral fractures: a cadaveric and biomechanical evaluation under cyclic loads.J Orthop Trauma. 2003; 17: 22-31
- Closed reduction and iliosacral percutaneous fixation of unstable pelvic ring fractures.Injury. 2008; 39: 869-874
- Mapping the columns of the acetabulum—implications for percutaneous fixation.Injury. 2010; 41: 339-342
- Posterior stabilization of pelvic fractures by use of threaded compression rods. Case reports and mechanical testing.Clin Orthop Relat Res. 1985; : 240-254
- Internal fixation for the transforaminal sacral fracture.Clin Orthop Relat Res. 1996; : 202-209
- Biomechanics of pelvic fixation.Orthop Clin North Am. 1997; 28: 351-367
- Biomechanical simulation of the anteroposterior compression injury of the pelvis. An understanding of instability and fixation.Clin Orthop Relat Res. 1994; : 245-256
- Anterior versus posterior provisional fixation in the unstable pelvis. A biomechanical comparison.Clin Orthop Relat Res. 1995; : 245-251
- Box plate fixation of the symphysis pubis: biomechanical evaluation of a new technique.J Orthop Trauma. 1994; 8: 483-489
- Internal fixation of the unstable anterior pelvic ring: a biomechanical comparison of standard plating techniques and the retrograde medullary superior pubic ramus screw.J Orthop Trauma. 1994; 8: 476-482
- The unstable iliac fracture: a biomechanical evaluation of internal fixation.Injury. 1997; 28: 469-475
- Effectiveness and complications of pelvic circumferential compression devices in patients with unstable pelvic fractures: a systematic review of literature.Injury. 2009; 40: 1031-1035
- Anterior and posterior internal fixation of vertical shear fractures of the pelvis.J Orthop Res. 1991; 9: 237-245
- Pelvic packing or angiography: competitive or complementary?.Injury. 2009; 40: 343-353
- Effect of a new pelvic stabilizer (T-POD) on reduction of pelvic volume and haemodynamic stability in unstable pelvic fractures.Injury. 2010; 41: 1017-1021
- New imaging method for assessing pelvic floor biomechanics.Ultrasound Obstet Gynecol. 2008; 31: 201-205
- A biomechanical comparison of different types of lumbopelvic fixation.Spine (Phila Pa 1976). 2009; 34: E866-E872
- Sacroiliac screw fixation for tile B fractures.J Trauma. 2003; 55: 962-965
- Cyclic loading of sacroiliac screws in Tile C pelvic fractures.J Trauma. 2005; 58: 1029-1034
- Biomechanical comparison of sacroiliac screw techniques for unstable pelvic ring fractures.J Orthop Trauma. 2004; 18: 589-595
- Putative proprioceptive function of the pelvic ligaments: biomechanical and histological studies.Injury. 2008; 39: 858-864
- Effects of method of internal fixation of symphyseal disruptions on stability of the pelvic ring.Injury. 1995; 26: 75-80
- Haemodynamically unstable pelvic fractures.Injury. 2009; 40: 1023-1030
- Unstable fractures of the pelvis treated by external fixation.J Bone Joint Surg Am. 1982; 64: 1010-1020
- Biomechanical comparison of posterior pelvic ring fixation.J Orthop Trauma. 2003; 17: 481-487
- Effect of iliac screw insertion depth on the stability and strength of lumbo-iliac fixation constructs: an anatomical and biomechanical study.Spine (Phila Pa 1976). 2009; 34: E565-E572
- The effect of screw length and bone cement augmentation on the fixation strength of iliac screws: a biomechanical study.J Spinal Disord Tech. 2009; 22: 545-550
Article info
Publication history
Accepted:
October 1,
2010
Identification
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© 2010 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.