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首页> 外文期刊>Injury >Simultaneous anterior and posterior compression of the pelvic ring with external fixation using a pre-tensed curved bar: A biomechanical study
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Simultaneous anterior and posterior compression of the pelvic ring with external fixation using a pre-tensed curved bar: A biomechanical study

机译：使用预张紧的曲杆同时进行骨盆环的前后加压和外固定，同时进行生物力学研究

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Introduction External fixators continue to be essential tools in the urgent treatment of pelvic fractures for compression and stabilization of the pelvic ring. Current systems fail to produce simultaneous anterior and posterior compression. A modified application of an existing curved bar fixator is proposed using a specifically designed tensioner to pre-tense the bar prior to its connection to Schanz screws. Subsequent pre-tension release and elastic recovery of the bar could potentially compress the pelvis. The aim of this work was to determine if the modified application could produce greater simultaneous compression across the sacroiliac joint and the symphysis of an unstable fractured pelvis than the standard application without pretension. Materials and methods Six synthetic pelvis models with symphyseal and unilateral sacroiliac joints disruptions, simulating a Tile type C pelvic ring fracture, were used. Each specimen was stabilized using two 5 mm × 250 mm supra-acetabular Schanz pins, a couple of open adjustable clamps and a semicircular carbon fibre rod applied without and with pre-tension. Two distances from bar to bone and three levels of pretension were compared. Each pelvis was tested with the six possible parameter combinations. Compressive forces at the disrupted joints were measured using pressure sensitive film sensors. Results The modified application produced forces significantly higher than the minimal compression achieved with standard application. At the sacroiliac joint, after pre-tension release, mean compressive forces measured ranged from 28.7 to 85.6 N. The closest bar-to-bone distance always produced a significantly higher force; similarly, a significant increase in compression was found as the pre-tension level rose. At the symphysis, mean compressive forces between 35.3 N and 49.0 N were determined. No significant variations were seen with changes of any of the two factors analyzed Conclusions To pre-tense a semi-circular bar before its use for external fixation of the fractured pelvis, is an effective means of applying compression simultaneously through the sacroiliac joint and the symphysis. The proposed method generates the highest compressive forces at the sacroiliac joint when the rod is subject to the highest pre-tension level not producing subluxation and is subsequently positioned as close as possible to the bone depending on patient's condition.
机译：简介外用固定器仍然是紧急治疗骨盆骨折以压迫和稳定骨环的必不可少的工具。当前的系统无法同时产生前后压缩。提出了对现有弯曲杆固定器的改进应用，该方法使用专门设计的张紧器在将杆连接到Schanz螺钉之前对其进行预张紧。随后的预张力释放和杆的弹性恢复可能会压迫骨盆。这项工作的目的是确定改良的应用是否比没有预拉伸的标准应用能产生更大的同时simultaneous骨关节同时压迫和不稳定的骨折骨盆的联合。材料和方法使用了六个具有骨s和单侧sa关节破坏的合成骨盆模型，模拟了Tile型C型骨盆环骨折。每个样品使用两个5 mm×250 mm髋臼上Schanz销钉，两个可调节的开口夹钳和一个半圆形碳纤维棒（不带预紧力和预紧力）稳定。比较了从杆到骨头的两个距离和三个水平的预紧力。用六个可能的参数组合测试每个骨盆。使用压敏薄膜传感器测量在破裂的关节处的压力。结果修改后的应用产生的力明显高于标准应用所达到的最小压缩力。在pre关节释放预张力后，测得的平均压缩力范围为28.7至85.6N。最接近的杆到骨距离始终会产生明显更高的力。类似地，发现随着前张力水平的升高，压迫力明显增加。在共点处，确定了35.3 N和49.0 N之间的平均压缩力。结论在将半圆形筋骨用于骨折骨盆的外部固定之前，先将其拉紧，这是同时通过compression关节和耻骨联合加压的有效方法。当杆经受最高的预拉伸水平而不产生半脱位时，所提出的方法在sa关节处产生最高的压力，然后根据患者的状况将其尽可能地靠近骨骼放置。

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