Mechanical testing of a device for subcutaneous internal anterior pelvic ring fixation versus external pelvic ring fixation

Abstract

Background: Although useful in the emergency treatment of pelvic ring injuries, external fixation is associated with pin tract infections, the patient's limited mobility and a restricted surgical accessibility to the lower abdomen. In this study, the mechanical stability of a subcutaneous internal anterior fixation (SIAF) system is investigated. Methods. A standard external fixation and a SIAF system were tested on pairs of Polyoxymethylene testing cylinders using a universal testing machine. Each specimen was subjected to a total of 2000 consecutive cyclic loadings at 1 Hz with sinusoidal lateral compression/distraction (+/-50 N) and torque (+/- 0.5 Nm) loading alternating every 200 cycles. Translational and rotational stiffness were determined at 100, 300, 500, 700 and 900 cycles. Results: There was no significant difference in translational stiffness between the SIAF and the standard external fixation when compared at 500 (p =.089), 700 (p =.081), and 900 (p =.266) cycles. Rotational stiffness observed for the SIAF was about 50 percent higher than the standard external fixation at 300 (p =.005), 500 (p =.020), and 900 (p =.005) cycles. No loosening or failure of the rod-pin/rod-screw interfaces was seen. Conclusions: In comparison with the standard external fixation system, the tested device for subcutaneous internal anterior fixation (SIAF) in vitro has similar translational and superior rotational stiffness. © 2014 Osterhoff et al.; licensee BioMed Central Ltd.