Anterior Stabilization in the Pubic Symphysis Separation : A Mechanical Testing

SARANATRA WAIKAKUL, M.D.*, KRABKAEW SOPARAT, M.Sc.*, THOSSART HARNROONGROJ, M.D.*

Affiliation : * Department of Orthopaedic Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700,Thailand.

AbstractFour types of commonly used instruments, I) external fixation, 2) tension wiring, 3) ten- sion band wiring, and 4) single superior plating, for anterior stabilization of the diastasis pubic symphysis were tested for their mechanical properties under single load to failure in cadaveric pelvis by a universal testing machine. Three directions of loading, transverse tension, vertical tension and saggital compression, were used to test each type of instrumentation. Five specimens of each fixation were used for each direction of testing. The strongest instrumentation was single superior plating. Early mobilization can be advocated in the patient after fixation with this instrument. External fixation could resist transverse and saggital compression load at an acceptable level but not the vertical load. Tension band wiring could better resist vertical load than the other directions. Tension wiring was the weakest instrumentation and early ambulation should be avoided.

Keywords : Pubic Symphysis Separation - Anterior Stabilization - Mechanical Testing

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