| 1Biomechanical function of the ligaments in the pelvic stabilityObjective: Pelvic fracture is a serious trauma. To the unstable pelvic fractures. The majority of authors agree that the clinical results of patients treated surgically are superior to those in patients treated nonoperatively. But the biomechanical function of the ligaments in the pelvic stability has not got much attention. So we carry out this experiment to shed light on this problem.Methods: Ten embalmed pelves plus the proximal lemora were harvested for this study. All of these specimens were visually examined and then X-rayed to exclude the presence of pelvic bone or soft tissue disease. Care was taken to preserve the hip capsules, symphysis pubis, sacroiliac joint, sacrotuberous and sacrospinons ligaments. Each specimen was loaded by vertical compression through the lumbar spine in standing position. The loads were applied at the speed of 5mm/min. It was increased in a continuous fashion until it reached 400N. A progressively more severe AP compression injury was simulated after intact testing by disrupting the following structures in sequence ①symphysis pubis ligament ②Left anterior and interosseous sacroiliac joint ligaments and capsule ③Left sacrospinous and sacrotuberous ligaments. In every step, the following data were recorded: the symphysis pubis gap displacement, the sacroiliac joint gap displacement and the sacroiliac joint angulation, Differences were tested at the p<0.05 level using a repeated measures analysis of variance and q-test.Results: ①In an intact pelvis, the sacroiliac joint gap displacement, the symphysis pubis gap displacement and the sacroiliac joint angulation were as follows: 0.039+/-0.012mm, 0.059+/-0.021mm and 0.458+/-0.130.②Sectioning the symphsis pubis, the sacroiliac joint gap displacement, the symphysis pubis gap displacement and the sacroiliac joint angulation were as follows: 0.060+/-0.019mm, 1.314+/-0.116mm and 0.454+/-0.126°The symphysis pubis joint motion increased to 0.06+/-0.019mm. The sacroiliac joint motion was not increased.③Sectioning the anterior and interosseous sacroiliac ligaments , the sacroiliac joint gap displacement ,the symphysis pubis gap displacement and the sacroiliac joint angulation were as follows: 0.327+/-0.110mm, 1.326+/-0.129mm and 0.898+/-0.231. The gap displacement was increased to 0.327+/-0.110mm. The angulation was increased to 0.898+/-0.231°.We found no further increase in the symphsis pubis joint motion.④Sectioning the sacrospinous and sacrotuberous ligaments, the sacroiliac joint gap displacement, the symphysis pubis gap displacement and the sacroiliac joint angulation were as follows: 0.347+/-0.101mm, 1.352+/-0.132mm and 0.946+/-0.263. It had little effect on the sacroiliac and symphysis pubis joint.Conclusions: ①The symphysis pubis ligaments contribute most to the symphysis pubis joint stability, but not the sacroiliac joint stability.②The anterior and interosseous sacroiliac ligaments contribute most to the sacrolilac joint stability but not the symphysis pubis joint stability. ③The sacrospinous and sacrotuberous ligaments have little effect on the pelvic stability.④The posterior sacroiliac ligaments complex contribute most to the sacroiliac joint stability.Key words: Pelvis, Ligament, Stability, Biomechanics.2Treatment of rotationally unstable pelvic fracturesObjective: As the development of traffic and building, the frequency of pelvic fracture was increasing. Although the medicine continued to improve, the mortility remained as high as about 10%. The traditional treatments were conservative treatment, such as traction, pelvic sling, plaster et al, and the morbitidy was as high as about 50%-60%. Since the 1980s, foreign researchers had used open reduction internal fixation (ORIF)for rotationally unstable pelvic fractures. This study was designed to investigate the treatment of rotationally unstable pelvic fractures.Methods: Sixty-nine patients with pelvic ring injuries were observed for an average of 41months... |
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