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True compression of pelvic fractures under lateral impact

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Abstract

Purpose

To promote the understanding of pelvic fracture mechanism and make more accurate evaluation of maximal deformity at the moment of fracture, kinematic response of pelvis to lateral impact and the difference between peak and final displacement were investigated.

Methods

A total of three human cadaver pelves were seated uprightly on a sled test table, explored to horizontal lateral impact by a 22.1-kg impactor at a speed of 5.2, 4.0, and 4.8 m/s. Kinematic data of pelvic osseous interesting points (POIP) were measured by the motion capture system. Trajectories of POIP, duration of impact, and deflection of pelvis were calculated as well as rotational movement of pelvis was evaluated. After impact, autopsy and CT scan were made to validate the motion capture data.

Results

The peak deflection of pelvis under lateral impact was 31.9, 30.1, and 18.5%, while final deflection was 19.6, 13.8, and 13.8%. The final deflection was only 61.5, 45.9, and 74.46% of the peak deflection.

Conclusions

In clinical practice, pelvic fracture displacement tends to be underestimated. The peak compression can be 1.3–2.2 times of final compression appearing on images in hospital. Clinicians shall give adequate estimation of displacement and related injuries.

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Acknowledgments

The authors wish to acknowledge associated professor Dongmei Wang for her work in providing advice for sled table test.

Funding

This study was supported by Dr. Qiugen Wang’s National Natural Science Foundation of China (No. 81272002). All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

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Authors and Affiliations

  1. Trauma Center, Shanghai General Hospital of Nanjing Medical University, 650 Xin Songjiang Road, Shanghai, 201620, Shanghai, China

    Zhijian Ma, Zizheng Wu, Chun Bi, Xiangsen Zeng & Qiugen Wang

  2. Trauma Center, The Second People’s Hospital of Yunnan Province, 176 Qingnian Road, Kunming, 650021, China

    Zhijian Ma & Liping Bai

  3. School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China

    Aili Qu

Authors
  1. Zhijian Ma
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  2. Zizheng Wu
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  3. Liping Bai
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  4. Chun Bi
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  5. Xiangsen Zeng
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  6. Aili Qu
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  7. Qiugen Wang
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Contributions

Zhijian Ma designed the study, analyzed the data, and drafted the manuscript. Zizheng Wu, Liping Bai, Chun Bi, Xiangsen Zeng, and Aili Qu participated in the experiment and measurement. Liping Bai helped draft the manuscript. Qiugeng Wang prepared the supporting grant, provided advice for experiment design and analysis, and revised the manuscript. All authors have reviewed and approved the final manuscript.

Corresponding author

Correspondence to Qiugen Wang.

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Conflict of the interest

The authors declare that they have no conflict of interest.

Ethical approval

Each author certifies that Shanghai Jiao Tong University approved the human protocol for this investigation that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Ma, Z., Wu, Z., Bai, L. et al. True compression of pelvic fractures under lateral impact. International Orthopaedics (SICOT) 43, 1679–1683 (2019). https://doi.org/10.1007/s00264-018-4052-2

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  • DOI: https://doi.org/10.1007/s00264-018-4052-2

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