Pt. Simonian et al., ANTERIOR VERSUS POSTERIOR PROVISIONAL FIXATION IN THE UNSTABLE PELVIS- A BIOMECHANICAL COMPARISON, Clinical orthopaedics and related research, (310), 1995, pp. 245-251
Pelvic ring injuries with associated hemorrhage often require provisio
nal fixation to achieve tamponade. Biomechanics information regarding
these provisional fixators is unknown. Six fresh-frozen cadaveric pelv
ic specimens were physiologically loaded, first intact and then after
each of the following modifications: disrupted-unilateral superior and
inferior rami osteotomies, ipsilateral anterior and posterior sacroil
iac joint, and sacrospinous and sacrotuberous ligament disruption; dis
rupted and with placement of a Ganz pelvic resuscitation clamp; and di
srupted and with placement of a simple anterior 2-bar external fixator
. This injury resulted in significant motion at the disrupted rami and
the injured sacroiliac joint, compared with the intact pelvic specime
n. Motions at the superior ramus and injured sacroiliac joints were si
gnificantly (p < 0.05) greater than the intact specimen, with both the
external fixator and the Ganz clamp. Motions at the superior ramus an
d injured sacroiliac joints were not significantly (p < 0.05) differen
t when comparing the Ganz clamp to the external fixator. However, the
anterior external fixator decreased motion to a greater degree at the
disrupted rami, whereas the Ganz clamp decreased motion to a greater d
egree at the disrupted sacroiliac joint.