Objectives: Anterior external fixation for pelvic ring fractures has shown to effectively improve stability and reduce mortality. However, these fixators can be associated with substantial morbidity such as pin tract infection, premature loss of fixation, and decreased quality of life in patients. Recently, two new methods of subcutaneous anterior pelvic internal fixation have been developed; the INFIX and the Pelvic Bridge. These methods have the purported advantages of lower wound complications, less surgical site pain, and improved quality of life. We sought to investigate the measured distances to critical anatomic structures, as well as the qualitative and topographic differences notable during implantation of both devices in the same cadaveric specimen. Materials and methods: The Pelvic Bridge and INFIX were implanted in eleven fresh cadavers. Distances were then measured to: the superficial inguinal ring, round ligament, spermatic cord, lateral femoral cutaneous nerve (LFCN), femoral nerve, femoral artery, and femoral vein. Observations regarding implantation and topography were also recorded. Results: The INFIX had greater measured distances from all structures except for the LFCN, in which its proximity placed this structure at risk. Neither device appears to put other critical structures at risk in the supine position. Significant implantation and topographic differences exist between the devices. The INFIX application lacked “safety margins” concerning the LFCN in 10/11 (90.9%) specimens, while Pelvic Bridge placement lacked “safety margins” with regard to the right superficial ring (1/11, 9%) and the right spermatic cord (1/11, 9%). Conclusions: Both the Pelvic Bridge and INFIX lie at safe distances from most critical pelvic structures in the supine position, though INFIX application places the LFCN at risk.
Bibliographical noteFunding Information:
This project was funded through the AOTNA Trauma Fellowship Research Grant . The acceptance of this grant did not play a role in the study design; collection, analysis and interpretation of data; the writing of the manuscript; but did require submission to Clinical Orthopaedics and Related Research for right of first refusal.
© 2017 Elsevier Ltd
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- Anterior pelvic internal fixation
- Inguinal ligament
- Pelvic Bridge
- Pelvic ring