Comparison of Three Different Pelvic Circumferential Compression Devices: A Biomechanical Cadaver Study

Knops, S. P.; Schep, N. W. L.; Spoor, C. W.; van Riel, M. P. J. M.; Spanjersberg, W. R.; Kleinrensink, G. J.; van Lieshout, E. M. M.; Patka, P.; Schipper, I. B.
February 2011
Journal of Bone & Joint Surgery, American Volume;2/2/2011, Vol. 93-A Issue 3, p230
Academic Journal
Background: Pelvic circumferential compression devices are designed to stabilize the pelvic ring and reduce the volume of the pelvis following trauma. It is uncertain whether pelvic circumferential compression devices can be safely applied for all types of pelvic fractures because the effects of the devices on the reduction of fracture fragments are unknown. The aim of this study was to compare the effects of circumferential compression devices on the dynamic realignment and final reduction of the pelvic fractures as a measure of the quality of reduction. Methods: Three circumferential compression devices were evaluated: the Pelvic Binder, the SAM Sling, and the T-POD. In sixteen cadavers, four fracture types were generated according to the Tile classification system. Infrared retroreflective markers were fixed in the different fracture fragments of each pelvis. The circumferential compression device was applied sequentially in a randomized order with gradually increasing forces applied. Fracture fragment movement was studied with use of a three-dimensional infrared video system. Dynamic realignment and final reduction of the fracture fragments during closure of the circumferential compression devices were determined. A factorial repeated-measures analysis of variance with pairwise post hoc comparisons was performed to analyze the differences in pulling force between the circumferential compression devices. Results: In the partially stable and unstable (Tile type-B and C) pelvic fractures, all circumferential compression devices accomplished closure of the pelvic ring and consequently reduced the pelvic volume. No adverse fracture displacement (>5 mm) was observed in these fracture types. The required pulling force to attain complete reduction at the symphysis pubis varied substantially among the three different circumferential compression devices; with a mean (and standard error of the mean) of 43 ± 7 N for the 1-POD, 60 ± 9 N for the Pelvic Binder, and 112 ± 10 N for the SAM Sling. Conclusions: The Pelvic Binder, SAM Sling, and 1-POD provided sufficient reduction in partially stable and unstable (Tile type-B1 and C) pelvic fractures. No undesirable overreduction was noted. The pulling force that was needed to attain complete reduction of the fracture parts varied significantly among the three devices, with the T-POD requiring the lowest pulling force for fracture reduction. Clinical Relevance: The results of this biomechanical cadaver study suggest that circumferential compression devices can provide early, noninvasive circumferential compression in partially stable and unstable pelvic fractures for advantageous realignment and reduction of these fractures without overreduction. Clinical effectiveness of circumferential compression devices in patients with pelvic ring fractures remains to be determined.


Related Articles

  • Clinical pathways for fragility fractures of the pelvic ring: personal experience and review of the literature. Rommens, Pol; Ossendorf, Christian; Pairon, Philip; Dietz, Sven-Oliver; Wagner, Daniel; Hofmann, Alexander // Journal of Orthopaedic Science;Jan2015, Vol. 20 Issue 1, p1 

    Fragility fractures of the pelvic ring (FFP) are increasing in frequency and require challenging treatment. A new comprehensive classification considers both fracture morphology and degree of instability. The classification system also provides recommendations for type and invasiveness of...

  • Is Fixation Failure After Plate Fixation of the Symphysis Pubis Clinically Important? Morris, Stephen; Loveridge, Jeremy; Smart, David; Ward, Anthony; Chesser, Tim // Clinical Orthopaedics & Related Research;Aug2012, Vol. 470 Issue 8, p2154 

    Background: Plate fixation is a recognized treatment for pelvic ring injuries involving disruption of the pubic symphysis. Although fixation failure is well known, it is unclear whether early or late fixation failure is clinically important. Questions/purposes: We therefore determined (1) the...

  • ILIZAROV FOR PELVIC FRACTURES. Ramalingam, Aruchamy; Vasanthapriya, Subramaniyam; Choy Yee Yi; Chong Ying Jiun; srinivas, Prem // International Online Medical Conference (IOMC) Conference Procee;2010, Vol. 1 Issue 1, p316 

    Aim of the study: We aim to use ilizarov method to correct the displacement of fragments in pelvic fractures in patients who are not fit for anaesthesia. As the procedure requires only local anaesthesia, it can be performed even at any peripheral centers.

  • Systemic Administration of PTH 1-84 for Fracture Repair: An Exciting Prospect. Einhorn, Thomas A. // Journal of Bone & Joint Surgery, American Volume;9/7/2011, Vol. 93-A Issue 17, pe102-1 

    The author discusses a report within the issue, "Parathyroid Hormone 1-84 Accelerates Fracture-Healing in Pubic Bones of Elderly Osteoporotic Women," by Peter Peichl and team. The study found that parathyroid hormone (PTH) adjuvant therapy improved healing times and functional outcomes in pelvic...

  • Pelvic ring injuries. Cooper, Julian // Trauma;Apr2006, Vol. 8 Issue 2, p95 

    Pelvic ring injuries exhibit a wide spectrum of severity; at times devastating with potentially serious immediate and long-term consequences. The anatomical and mechanistic basis of the injured pelvis is described. The non-operative and surgical management of pelvic ring disruption in the acute...

  • ischium. Peters, Michael // BMA A-Z Family Medical Encyclopedia;2004, p438 

    An encyclopedia entry for "ischium" is presented. It is one of the bones that form the lower part of the pelvis.

  • Identifying Occult Arterial Bleeding by a Relaxing (Loosening) Pelvic Stabilization Device in Severe Pelvic Fracture. Klune, John R.; Amesur, Nikhil B.; Bautz, Joshua T.; Puyana, Juan Carlos // American Surgeon;Feb2013, Vol. 79 Issue 2, pE80 

    The article discusses a case in which occult arterial bleeding was identified when a relaxing or loosening pelvic stabilization device was used in the treatment of a severe pelvic fracture in a 40-year-old man who was in a motorcycle accident. The article notes diagnostic peritoneal lavage (DPL)...

  • The Multiply Injured Trauma Patient: Resuscitation, Rehabilitation, Recovery. Gregg, Shea C.; Heffernan, Daithi S.; Legere, Jason T.; Lilly, Helen M.; Kinsler, Annah; Muschiano, Amy B.; McDonnell, Moira K.; Tober, Kelly L.; Smith, Amy L.; Harrington, David T.; Adams Jr., Charles A. // Medicine & Health Rhode Island;Apr2010, Vol. 93 Issue 4, p112 

    The article discusses the processes of resuscitation, medical rehabilitation, and recovery among trauma patients with multiple injuries. A case of a 73-year-old man is presented with injuries sustained from a ladder fall, resulting to a fractured pelvis with links of tachycardia and hypotension....

  • Comment on Shetty et al.: Ipsilateral hip and femoral shaft fractures treated with intramedullary nails. Joshi, Anil; Singh, Baldeep; Singhal, Deepak // International Orthopaedics;Aug2007, Vol. 31 Issue 4, p579 

    A letter to the editor is presented in response to the article "Ipsilateral Hip and Femoral Shaft Fractures Treated With Intramedullary Nails" by M. Shantharam Shetty and colleagues.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics