The human pelvis is susceptible to severe injury in vehicle side impacts owing to its close proximity to the intruding door and unnatural loading through the greater trochanter. Whereas fractures of the pelvic bones are diagnosed with routine radiographs (x-rays) and computerized tomography (CT scans), non-displaced damage to the soft tissues of pubic symphysis joints may go undetected. If present, trauma-induced joint laxity may cause pelvic instability, which has been associated with pelvic pain in non-traumatic cases. In this study, mechanical properties of cadaveric pubic symphysis joints from twelve normal and eight laterally impacted pelves were compared. Axial stiffness and creep responses of these isolated symphyses were measured in tension and compression (perpendicular to the joint). Bending stiffness was determined in four primary directions followed by a tension-to-failure test. Loading rate and direction correlated significantly p<0.05 with stiffness and tensile strength of the unimpacted joints, more so than donor age or gender. The impacted joints had significantly lower stiffness in tension p<0.04, compression p<0.003, and posterior bending p<0.03, and more creep under a compressive step load p<0.008 than the unimpacted specimens. Tensile strength was reduced following impact, however, not significantly. We concluded that the symphysis joints from the impacted pelves had greater laxity, which may correlate with post-traumatic pelvic pain in some motor vehicle crash occupants.

1.
Gamble
,
J. G.
,
Simmons
,
S. C.
, and
Freedman
,
M.
,
1986
, “
The Symphysis Pubis: Anatomical and Pathological Considerations
,”
Clin. Orthop. Relat. Res.
,
203
, pp.
251
272
.
2.
King, A. I., 1985, “Pelvis,” in: Review of Biomechanical Impact Response and Injury in the Automotive Environment, U.S. Department of Transportation, National Highway Traffic Safety Administration, Washington, DC, pp. 147–161.
3.
Tohno
,
S.
,
Tohno
,
Y.
,
Minami
,
T.
,
Okazaki
,
Y.
,
Utsumi
,
M.
,
Moriwake
,
Y.
,
Nishiwaki
,
F.
, and
Yamada
,
M.
,
1997
, “
High Accumulations of Calcium and Phosphorus in Women’s Pubic Symphysis
,”
Biol. Trace Elem. Res.
,
59
, pp.
177
185
.
4.
Neznakomtseva
,
E. P.
, and
Lomov
,
I. G.
,
1993
, “
The Micro and Ultrastructural Organization of Mineralized Cartilage in the Human Pubic Symphysis
,”
Morfologiia
,
104
, pp.
90
100
.
5.
Sgambati
,
E.
,
Stecco
,
A.
,
Capaccioli
,
L.
, and
Brizzi
,
E.
,
1996
, “
Morphometric Evaluation of the Symphysis Pubis Joint
,”
Ital. J. Anat. Embryol.
,
101
, pp.
195
201
.
6.
Jackes
,
M. K.
,
1985
, “
Pubic Symphysis Age Distributions
,”
Am. J. Phys. Anthropology
,
68
, pp.
281
299
.
7.
Sinha
,
A.
, and
Gupta
,
V.
,
1995
, “
A Study on Estimation of Age From Pubic Symphysis
,”
Forensic Sci. Int.
,
75
, pp.
73
78
.
8.
Walheim
,
G.
,
Olerud
,
S.
, and
Ribbe
,
T.
,
1984
, “
Mobility of the Pubic Symphysis: Measurements by an Electromechanical Method
,”
Acta Orthop. Scand.
,
55
, pp.
203
208
.
9.
Meissner
,
A.
,
Fell
,
M.
,
Wilk
,
R.
,
Boenick
,
U.
, and
Rahmanzadeh
,
R.
,
1996
, “
Biomechanics of the Pubic Symphysis: Which Forces Lead to Mobility of the Symphysis in Physiological Conditions?
Unfallchirurg
,
99
, pp.
415
421
.
10.
Burgess
,
A. R.
,
Eastridge
,
B. J.
,
Young
,
W. R.
,
Ellison
,
T. S.
,
Ellison
,
P. S.
,
Poka
,
A.
,
Bathon
,
G. H.
, and
Brumback
,
R. J.
,
1990
, “
Pelvic Ring Disruptions: Effective Classification System and Treatment Protocols
,”
J. Trauma
,
30
, pp.
848
856
.
11.
Letournel, E., and Judet, R., 1993, Fractures of the Acetabulum, Springer-Verlag, Berlin.
12.
Nahum, A. M., Seigel, A. W., Hight, P. V., and Brooks, S. H., 1968, “Lower Extremity Injuries of Front Seat Occupants,” Soc. Automotive Engineers, SAE #680483, pp. 1–17.
13.
Nerubay
,
J.
,
Glancz
,
G.
, and
Katznelson
,,
A.
,
1973
, “
Fractures of the Acetabulum
,”
J. Trauma
,
13
, pp.
1050
1062
.
14.
Alonso
,
J. E.
,
Lee
,
J.
,
Burgess
,
A. R.
, and
Browner
,
B. D.
,
1996
, “
The Management of Complex Orthopedic Injuries
,”
Surg. Clin. North Am.
,
76
, pp.
879
903
.
15.
Hofmann
,
A. A.
,
Dahl
,
C.
, and
Wyatt
,
R. W. B.
,
1984
, “
Experience With Acetabular Fracture
,”
J. Trauma
,
24
, pp.
750
752
.
16.
States, J. D., 1986, “Adult Occupant Injuries of the Lower Limb,” Soc. Automotive Engineers, SAE #861927, pp. 97–107.
17.
Tile
,
M.
,
1988
, “
Pelvic Ring Fractures: Should They Be Fixed?
J. Bone Jt. Surg., Br. Vol.
,
70-B
, pp.
1
12
.
18.
Dischinger
,
P. C.
,
Cushing
,
B. M.
, and
Kerns
,
T. J.
,
1993
, “
Injury Patterns Associated With Direction of Impact: Drivers Admitted to Trauma Centers
,”
J. Trauma
,
35
, pp.
454
459
.
19.
Siegel
,
J. H.
,
Mason-Gonzalez
,
S.
,
Dischinger
,
P. C.
,
Cushing
,
B.
,
Read
,
K.
,
Robinson
,
R.
,
Smialek
,
J.
,
Heatfield
,
B.
,
Hill
,
W.
,
Bents
,
F.
,
Jackson
,
J.
,
Livingston
,
D.
, and
Clark
,
C. C.
,
1993
, “
Safety Belt Restraints and Compartment Intrusions in Frontal and Lateral Motor Vehicle Crashes: Mechanics of Injuries, Complications, and Acute Care Costs
,”
J. Trauma
,
34
, pp.
736
758
.
20.
Gokcen
,
E. C.
,
Burgess
,
A. R.
,
Siegel
,
J. H.
,
Gonzalez
,
S. M.
,
Dischinger
,
P. C.
, and
Ho
,
S. M.
,
1994
, “
Pelvic Fracture Mechanism of Injury in Vehicular Trauma Patients
,”
J. Trauma
,
36
, pp.
789
796
.
21.
States, J. D., and States, D. J., 1968, “The Pathology and Pathogenesis of Injuries Caused by Lateral Impact Accidents,” Soc. Automotive Engineers, SAE #680773, pp. 72–93.
22.
Grattan
,
E.
, and
Hobbs
,
J. A.
,
1969
, “
Injuries to the Hip Joint in Car Occupants
,”
Br. Med. J.
,
1
, pp.
71
73
.
23.
Dakin
,
G. J.
,
Eberhardt
,
A. W.
,
Alonso
,
J. E.
,
Stannard
,
J. P.
, and
Mann
,
K. A.
,
1999
, “
Acetabular Fracture Patterns: Associations With Motor Vehicle Crash Information
,”
J. Trauma
,
46
, pp.
1063
1071
.
24.
Chamberlain
,
W. E.
,
1932
, “
The X-Ray Examination of the Sacroiliac Joint
,”
Del Med. J.
,
4
, pp.
195
201
.
25.
LaBan
,
M. M.
,
Meerschaert
,
J. R.
,
Taylor
,
R. S.
, and
Tabor
,
H. D.
,
1978
, “
Symphyseal and Sacroiliac Joint Pain Associated With Pubic Symphysis Instability
,”
Arch. Phys. Med. Rehabil.
,
59
, pp.
470
472
.
26.
Albertsen
,
A. M. B.
,
Egund
,
N.
, and
Jurik
,
A. G.
,
1995
, “
Fatigue Fractures of the Sacral Bone Associated With Septic Arthritis of the Symphysis Pubis
,”
Skeletal Radiol.
,
24
, pp.
605
607
.
27.
Arbelaez, R. A., Dakin, G. J., Molz, F. J., Alonso, J. E., Eberhardt, A. W., and Mann, K. A., 1998, “Pelvic Injury in Simulated Automobile Side Impact: Effects of Loading Rate on Fracture Etiology,” in: 1998 Advances in Bioengineering, A. Yoganathan, ed., ASME BED-Vol. 39, pp. 171–172.
28.
Molz, F. J., Go, L. S., Bidez, M. W., King, A. I., and Alonso, J. E., 1997, “Pubic Symphysis Motion and Overall Pelvic Compression During Simulated Automotive Side Impact: A Cadaveric Study of the Isolated Human Pelvis,” in: Proc. 7th Injury Prevention Through Biomechanics Symposium, Wayne State University, pp. 3–11.
29.
Cavanaugh, J. M., Walliko, T. J., Malhotra, A., Zhu, Y., and King, A. I., 1990, “Biomechanical Response and Injury Tolerance of the Pelvis in Twelve Sled Side Impacts,” Soc. Automotive Engineers, SAE #902305, pp. 1–12.
30.
Woo
,
S. L.
,
Orlando
,
C. A.
,
Camp
,
J. F.
, and
Akeson
,
W. H.
,
1986
, “
Effects of Postmortem Storage by Freezing on Ligament Tensile Behavior
,”
J. Biomech.
,
19
, pp.
399
404
.
31.
Simonian
,
P. T.
,
Routt
,
M. L.
,
Harrington
,
R. M.
,
Mayo
,
K. A.
, and
Tencer
,
A. F.
,
1994
, “
Biomechanical Simulation of the Anteroposterior Compression Injury of the Pelvis: An Understanding of Instability and Fixation
,”
Clin. Orthop. Relat. Res.
,
309
, pp.
245
256
.
32.
White, A. A., and Panjabi, M. M., 1990, “Physical Properties and Functional Biomechanics of the Spine,” in: Clinical Biomechanics of the Spine, J. B. Lippincott Company, Philadelphia, PA, pp. 3–76.
33.
Hult, J. A. H., 1966, “Constitutive Equations,” in: Creep in Engineering Structures, W. Prager and J. Kestin, eds., Blaisdell Publishing Company, Waltham, MA, pp. 15–37.
34.
Fung, Y. C., 1993, “The Meaning of the Constitutive Equation,” in: Biomechanics Mechanical Properties of Living Tissue, Springer-Verlag, New York, pp. 23–65.
35.
Tile, M., 1995, “Classification,” in: Fractures of the Pelvis and Acetabulum, Williams & Wilkins, Media, PA, pp. 66–101.
36.
Scholten
,
P. J. M.
,
Schultz
,
A. B.
,
Luchies
,
C. W.
, and
Miller
,
A. A.
,
1988
, “
Motions and Loads Within the Human Pelvis: A Biomechanical Model Study
,”
J. Orthop. Res.
,
6
, pp.
840
850
.
37.
Oloyede
,
A.
,
Flachmann
,
R.
, and
Broom
,
N. D.
,
1992
, “
The Dramatic Influence of Loading Velocity on the Compressive Response of Articular Cartilage
,”
Connective Tissue Research
,
27
, pp.
211
224
.
38.
Raftopoulos
,
D.
,
Katsamanis
,
E.
,
Saul
,
F.
,
Liu
,
W.
, and
Saddemi
,
S.
,
1993
, “
An Intermediate Loading Rate Technique for the Determination of Mechanical Properties of Human Femoral Cortical Bone
,”
J. Biomed. Eng.
,
15
, pp.
60
66
.
39.
Han
,
S.
,
Medige
,
J.
,
Faran
,
K.
,
Feng
,
Z.
, and
Ziv
,
I.
,
1997
, “
The Ability of Quantitative Ultrasound to Predict the Mechanical Properties of Trabecular Bone Under Different Strain Rates
,”
Med. Eng. Phys.
,
19
, pp.
742
747
.
40.
Neumann
,
P.
,
Osvalder
,
A. L.
,
Hansson
,
T. H.
, and
Nordwall
,
A.
,
1996
, “
Flexion-Distraction Injury of the Lumbar Spine: Influence of Load, Loading Rate, and Vertebral Mineral Content
,”
J. Spinal Disord.
,
9
, pp.
89
102
.
41.
Markolf
,
K. L.
,
1972
, “
Deformation of the Thoracolumbar Intervetebral Joints in Response to External Loads
,”
J. Bone Jt. Surg., Am. Vol.
,
54
(A), pp.
511
532
.
42.
Fricker
,
P. A.
,
Taunton
,
J. E.
, and
Ammann
,
W.
,
1991
, “
Osteitis Pubis in Athletes. Infection, Inflammation, or Injury?
Sports Med.
,
12
, pp.
266
279
.
43.
Mow
,
V. C.
,
Kuei
,
S. C.
,
Lai
,
W. M.
, and
Armstrong
,
C. G.
,
1980
, “
Biphasic Creep and Stress Relaxation of Articular Cartilage in Compression? Theory and Experiments
,”
ASME J. Biomech. Eng.
,
102
, pp.
73
84
.
44.
Armstrong
,
C. G.
, and
Mow
,
V. C.
,
1982
, “
Variations in the Intrinsic Mechanical Properties of Human Articular Cartilage With Age, Degeneration, and Water Content
,”
J. Bone Jt. Surg., Am. Vol.
,
64
-A, pp.
88
94
.
45.
Martin
,
R. B.
, and
Boardman
,
D. L.
,
1993
, “
The Effects of Collagen Fiber Orientation, Porosity, Density, and Mineralization on Bovine Cortical Bending Properties
,”
J. Biomech.
,
26
, pp.
1047
1054
.
46.
Currey
,
J. D.
,
Brear
,
K.
, and
Zioupos
,
P.
,
1995
, “
The Effects of Aging and Changes in Mineral Content in Degrading the Toughness of Human Femora
,”
J. Biomech.
,
29
, pp.
257
260
.
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