Anatomic progress of pubic symphysis and biomechanical characteristics of internal fixation / 中国组织工程研究

ABSTRACT

BACKGROUND: The separation injury of pubic symphysis is most commonly associated with severe pelvic fracture injuries. Because the anatomical position of the pubic symphysis is deep, and the curative effect is often unsatisfactory. Anatomical and biomechanical studies are necessary to better guide clinical diagnosis and treatment. OBJECTIVE: To summarize and analyze the anatomical characteristics and biomechanical research status of pubic symphysis, and to provide some benefits for the clinical treatment of pubic symphysis separation. METHODS: The authors retrieved CNKI, VIP, and PubMed with the key words of “separation of pubic symphysis” and “biomechanics” for articles published from April 1984 to February 2020. Relevant literature was selected by title and abstract, and the titles and abstracts of the references were read. The related literatures were selected again and the duplicate literatures were eliminated. RESULTS AND CONCLUSION: There were 57 eligible literatures, and 33 were finally included. (1) The present anatomical study mainly focuses on the structure of pubic symphysis and its adjacent ligaments. (2) Because of the position of pubic symphysis, no further study was carried out. The precise distribution of the starting and ending points of the peripheral ligaments and muscles, and the precise nerve and blood distribution need further study. (3) There have been relatively few studies of pubic symphysis biomechanics, and they vary widely. It needs to be deeply studied and agreed upon. (4) With the development of finite element, the biomechanics focus on the treatment of pubic symphysis. (5) Due to good mechanical stability, the reconstructed plate and the hollow screw are used as common fixation for pubic symphysis separation. However, percutaneous hollow screw fixation has become the trend in the future because of its minimal invasion.