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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2009 August;60(4):255-60
External pelvic fixation: morphometric study of the pelvis
Uslenghi M. 1, Alluto C. 2, Governale G. 2, Stucchi A. 2, Favuto M. 1, Massè A. 1,2
1 Dipartimento di Ortopedia e Traumatologia, Ospedale San Luigi Orbassano, Università degli Studi di Torino, Torino, Italia
2 Università degli Studi di Torino, Torino, Italia
Aim. External fixation is the mainstay of treatment for pelvic fractures. As such fractures are often associated with massive blood loss, they require immediate hemodynamic and pelvic stabilization. The aim of this study was to determine whether combined positioning of fixation screws can be standardized to could prevent screw malpositioning and permit a more rapid procedure.
Methods. The spatial dimensions of 12 cadaveric pelvises were measured on three planes and fixation screws were inserted using a combined technique (one on the iliac crest and one on the supra-acetabular groove) in order to measure the positioning angle of the second with respect to the first screw and to relate them to the dimension of the pelvis. The data were analyzed using multiple regression tests to determine possible correlations between pelvis dimension and screw inclination or a possible reproducibility of such angles in a population of pelvises with various different configurations.
Results. Comparison by linear regression analysis of the morphometric data showed statistically significant correlations (P<0.05) between the data. No statistically significant correlation emerged between pelvis dimension and screw inclination.
Conclusion. Based on these data it appears that an external fixation system can be used in which the direction and inclination of the second screw can be obtained from the screw positioned on the iliac crest, thus obviating the use of a brilliance amplifier in an emergency procedure.