Three-dimensional Analysis of Pelvic Volume in an Unstable Pelvic Fracture

Abstract

A model was developed to predict changes in pelvic volume associated with increasing pubic diastasis in unstable pelvic fractures. Intact and postfracture pelvic volumes were calculated in 10 cadavers using computerized axial tomography (CT). The true pelvis was assumed to be either a sphere, a cylinder, or a hemi-elliptical sphere. Using the appropriate equations for calculating the volume of each of these shapes, pelvic volume was predicted and then compared with the measured values. The observed volume changes associated with increasing pubic diastasis were much smaller than previously reported. The mean difference between the measured and predicted volume was 20.0 +/- 9.9% for the sphere, 10.7 +/- 6.5% for the cylinder, and 4.5 +/- 5.9% for the hemi-elliptical sphere. The differences between these means were statistically significant (p < 0.001). This data suggests that the hemi-elliptical sphere best describes the geometric shape of the true pelvis and better predicts quantitative changes in pelvic volume relative to an increasing pubic diastasis as the radius has little effect on the change in volume. Due to the small changes in volume observed with increasing diastasis, factors other than the absolute change in volume must account for the clinically observed effects of emergent pelvic stabilization.