Biomechanical aspects of the pelvic ring: a review

The biomechanics of the pelvic ring is essential for the treatment of injuries involving this anatomical region of the human body. Its study, with detailed knowledge of surgical anatomy, provides clinicians with a better understanding of the pathological destabilizing forces acting on the injured segment both at the moment of trauma and throughout the stages of surgical rehabilitation. This work aimed to present the fundamentals of a contemporary spatial and functional approach to the surgery of pelvic ring injuries. This lecture, intended primarily for trauma surgeons, describes both static and dynamic loads acting on the pelvis, as well as the corresponding changes occurring within the structures of the pelvic complex. The material examines the interaction of anatomical structures (the pelvis, lower extremities, and the lumbopelvic junction) that underlies the restoration of the injured patient’s functional capacity during surgical treatment. The relevance of this topic is driven by the high incidence of pelvic ring injuries (including those resulting from high-energy mechanisms), the complexity of their management, and the substantial functional impairments that arise following damage to this structure. Understanding the biomechanical principles governing pelvic ring function is critically important for the development of effective methods of surgical stabilization and rehabilitation. The review addresses the anatomical and functional characteristics of the pelvic ring as a closed biomechanical system, mechanisms of axial load transmission through the sacroiliac joints and the pubic symphysis, the role of the ligamentous apparatus in maintaining stability during various types of movement, and the biomechanical consequences of pelvic ring integrity disruption in injuries of different etiologies. The practical importance of this work is in the development of biomechanically grounded algorithms for selecting osteosynthesis techniques in pelvic ring injuries, which may reduce the risk of postoperative complications, optimize the timing of weight-bearing recovery, and improve patients’ quality of life in the long term. The findings may be applied in traumatology, orthopedics, and rehabilitation medicine to refine pelvic trauma management protocols and to prevent post-traumatic deformities.