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Anterior stabilization in the pubic symphysis separation: a mechanical testing
S Waikakul1, K Soparat, T Harnroongroj
1Department of Orthopaedic Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Summary
Single superior plating offers the strongest anterior stabilization for diastasis pubic symphysis injuries. This method allows for early patient mobilization, unlike tension wiring, which is the weakest fixation method.
Area of Science:
- Orthopedic surgery
- Biomechanics
- Trauma management
Background:
- Diastasis pubic symphysis requires stable anterior fixation.
- Commonly used instruments include external fixation, tension wiring, tension band wiring, and single superior plating.
Purpose of the Study:
- To compare the mechanical properties of four anterior stabilization methods for diastasis pubic symphysis.
- To determine the optimal fixation for early patient mobilization.
Main Methods:
- Four fixation types were tested in cadaveric pelvis specimens.
- Mechanical properties were evaluated using a universal testing machine under transverse tension, vertical tension, and sagittal compression.
- Five specimens per fixation type and loading direction were used.
Main Results:
- Single superior plating demonstrated the highest strength.
- External fixation showed acceptable resistance to transverse and sagittal loads, but not vertical loads.
- Tension band wiring resisted vertical loads better than other directions.
- Tension wiring was the weakest fixation method.
Conclusions:
- Single superior plating is the strongest and recommended for early mobilization after diastasis pubic symphysis fixation.
- Tension wiring is the weakest and necessitates avoiding early ambulation.