Stabilitv of two kinds of sacroiliac screw fixation of bilateral sacral fracture: a comparative study

( views:472, downloads:0 )
Author:
ZHAO Yong(Department of Orthopaedics, Yantaishan Hospital, Shandong Yantai 264008, China)
LI Jian-min()
ZHANG Shu-dong(Department of Orthopaedics, Yantaishan Hospital, Shandong Yantai 264008, China)
WANG Dan(Department of Orthopaedics, Yantaishan Hospital, Shandong Yantai 264008, China)
HANG Chuan-qiang(Department of Orthopaedics, Yantaishan Hospital, Shandong Yantai 264008, China)
QU Wen-qing(Department of Orthopaedics, Yantaishan Hospital, Shandong Yantai 264008, China)
XIN Da-jiang(Department of Orthopaedics, Yantaishan Hospital, Shandong Yantai 264008, China)
Journal Title:
Chinese Journal of Biomedical Engineering
Issue:
Volume 18, Issue 03, 2012
DOI:
10.3760/cma.j.issn.1674-1927.2012.03.014
Key Word:
Pelvis;Fractures,bone;Biomechanics;Finite element analysis;Sacroiliac screw

Abstract: Objective To compare the stability of lengthened or conventional sacroiliac screws in patients with bilateral sacral fracture by using various approaches for fixation.Methods Bilateral sacral longitudinal fracture models (Tile C) were constructed via three-dimensional finite element analysis and were subjected to virtual fixation by using 7 approaches in which lengthened or conventional sacroiliac screw was applied.Vertical and rotational stability of posterior pelvic ring was compared via mimicking standing conditions.Results After being loaded with 600 N vertically,each lengthened sacroiliac screw yielded higher fixation stability than 2 bidirectional conventional sacroiliac screws at both S1 and S2 planes,as shown by comparison on the downward translation and backward angle displacement at the superior surface of S1.The combination of lengthened sacroiliac screw at both S1 and S2 was evidenced to be of higher stability than 2 bidirectional conventional sacroiliac screws at each plane combined.Higher fixation stability was found in lengthened sacroiliac screws at both S1 and S2,but not at either plane.Additionally,fixation adopting 4 bidirectional conventional sacroiliac screws each at S1 and S2 conferred markedly higher stability than 2 bidircctional sacroiliac screws at either plane as well as at both planes.Both lengthened and conventional sacroiliac screws at S2 were superior to that at S1 in terms of vertical stability.Contrarily,both lengthened and conventional sacroiliac screws conferred preterable rotational stability at S1,but not at S2.Conclusion Lengthened sacroiliac screw at either S1 or S2,and in particular the combination of both planes,may be the candidates for Tile C bilateral sacral longitudinal fracture.

  • [1]Beaulé PE,Antoniades J,Matta JM.Trans-sacral fixation for failed posterior fixation of the pelvic ring.Arch Orthop Trauma Surg,2006,126:49-52.
  • [2]Gardner MJ,Routt ML Jr.Transiliac-transsacral screws for posterior pelvic stabilization.J Orthop Trauma,2011,25:378-384.
  • [3]Keating JF,Werier J,Blachut P,et al.Early fixation of the vertically unstable pelvis:the role of iliosacral screw fixation of the posterior lesion.J Orthop Trauma,1999,13:107-113.
  • [4]Griffin DR,Starr AJ,Reinert CM,et al.Vertically unstable pelvic fractures fixed with percutaneous iliosacral screws:does posterior injury patiern predict fixation failure? J Orthop Trauma,2003,17:399-405.
  • [5]Conflitti JM,Graves ML,Chip Routt ML Jr.Radiographic quantification and analysis of dysmorphic upper sacral osseous anatomy and associated iliosacral screw insertions.J Orthop Trauma,2010,24:630-636.
  • [6]van Zwienen CM,van den Bosch EW,Snijders CJ,et at.Biomechanical comparison of sacroiliac screw techniques for unstable pelvic ring fractures.J Orthop Trauma,2004,18:589-595.
  • [7]肖进,尹庆水,张美超,等.垂直载荷作用下骨盆的三维有限元分析.中国组织工程研究与临床康复,2008,12:7615-7619.
  • [8]Wood KB,Schendel MJ,Ogilvic JW,et al.Effect of sacral and iliac instrumentation on strains in the pelvis.A biomechanical study.Spine (Phila Pa 1976),1996,21:1185-1191.
  • [9]郭磊,赵玉岩,范广宇,等.垂直应力影响骨盆环应力分布的实验研究中国医科大学学报,2002,31:195-196.
  • [10]姬涛,高相飞,郭卫,等.骨盆环三维有限元模型的建立.中国组织工程研究与临床康复,2009,13:1625-1628.
  • [11]杨安礼,蔡珉巍,洪水棕,等.站、坐位态骨盆应力分布的实验研究.生物医学工程与临床,2002,6:206-208.
  • [12]Matta JM,Tornetta P 3rd.Internal fixation of unstable pelvic ring injuries.Clin Orthop Relat Res,1996(329):129-140.
  • [13]Vanderschot PM,Broens PM,Vermeire JI,et al.Trans iliac-sacraliliac bar stabilization to treat bilateral sacro-iliac joint disruptions.Injury,1999,30:637-640.
WanfangData CO.,Ltd All Rights Reserved
About WanfangData | Contact US
Healthcare Department, Fuxing Road NO.15, Haidian District Beijing, 100038 P.R.China
Tel:+86-010-58882616 Fax:+86-010-58882615 Email:yiyao@wanfangdata.com.cn