Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Dec 1994
Biomechanical simulation of the anteroposterior compression injury of the pelvis. An understanding of instability and fixation.
Seven fresh cadaveric pelvic specimens were biomechanically analyzed. Testing was first performed on intact pelves and then after progressive disruption of the (1) symphysis pubis, (2) unilateral anterior and interosseous sacroiliac ligaments and capsule, (3) ipsilateral sacrospinous and sacrotuberous ligaments; and fixation with a 4.5-mm narrow dynamic compression plate at the symphysis pubis, or a 4.5-mm narrow dynamic compression plate at the anterior sacroiliac joint with and without the symphysis pubis plate, or a 7.0-mm sacroiliac lag screw anchored into the S1 vertebral body with and without the symphysis pubis plate. Symphyseal gapping occurred after isolated symphysis pubis disruption. ⋯ Use of sacroiliac fixation alone without a symphysis pubis plate did not affect symphysis pubis motion. The symphysis pubis plate is the key to stabilizing symphysis pubis motion, and similarly, sacroiliac joint fixation is required to control sacroiliac joint motion. Both single iliosacral screws and plates produced equivalent decreases in sacroiliac joint motion.