Chapter 10 - Biomechanical Testing of the Intact and Surgically Treated Pelvis

Abstract

Pelvic fractures account for over one-tenth of all human bone fractures, but acetabular fractures account for about half of all pelvic fractures. Acetabular fractures can be simple (or elementary) and complex (or associated), being caused by a low-energy fall in the elderly and high-energy impact in the young. No “gold standard” exists for surgical repair of these injuries; however, surgeons most often use plate-and-screw fixation, although cable fixation may be used when osteoporosis prevents good screw fixation into bone. Acetabular fracture repair is often accompanied by simultaneous total hip arthroplasty for elderly patients who eventually require a hip prosthesis due to osteoarthritis. The goal of surgical repair is perfect anatomical reduction of the hip to minimize pain, improve strength, and restore function. A key element is the biomechanical stability provided by various acetabular fracture fixation methods. Therefore, this chapter shows how to surgically repair a pelvic acetabular fracture and perform biomechanical testing, as well as how to analyze, report, and interpret data.