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Fan S, Luo H, Chen S, Xiang H, Mai Q, Zhu Z, Chen Y, Hou Z, Chen W, Zhu Q, Zhang Y. Effect of different lumbar-iliac fixation and sacral slope for Tile C1.3 pelvic fractures: a biomechanical study. J Orthop Traumatol 2024; 25:32. [PMID: 38926180 PMCID: PMC11208344 DOI: 10.1186/s10195-024-00776-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 06/15/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Lumbar-iliac fixation (LIF) is a common treatment for Tile C1.3 pelvic fractures, but different techniques, including L4-L5/L5 unilateral LIF (L4-L5/L5 ULIF), bilateral LIF (BLIF), and L4-L5/L5 triangular osteosynthesis (L4-L5/L5 TOS), still lack biomechanical evaluation. The sacral slope (SS) is key to the vertical shear of the sacrum but has not been investigated for its biomechanical role in lumbar-iliac fixation. The aim of this study is to evaluate the biomechanical effects of different LIF and SS on Tile C1.3 pelvic fracture under two-legged standing load in human cadavers. METHODS Eight male fresh-frozen human lumbar-pelvic specimens were used in this study. Compressive force of 500 N was applied to the L4 vertebrae in the two-legged standing position of the pelvis. The Tile C1.3 pelvic fracture was prepared, and the posterior pelvic ring was fixed with L5 ULIF, L4-L5 ULIF, L5 TOS, L4-L5 TOS, and L4-L5 BLIF, respectively. Displacement and rotation of the anterior S1 foramen at 30° and 40° sacral slope (SS) were analyzed. RESULTS The displacement of L4-L5/L5 TOS in the left-right and vertical direction, total displacement, and rotation in lateral bending decreased significantly, which is more pronounced at 40° SS. The difference in stability between L4-L5 and L5 ULIF was not significant. BLIF significantly limited left-right displacement. The ULIF vertical displacement at 40° SS was significantly higher than that at 30° SS. CONCLUSIONS This study developed an in vitro two-legged standing pelvic model and demonstrated that TOS enhanced pelvic stability in the coronal plane and cephalad-caudal direction, and BLIF enhanced stability in the left-right direction. L4-L5 ULIF did not further improve the immediate stability, whereas TOS is required to increase the vertical stability at greater SS.
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Affiliation(s)
- Shicai Fan
- Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Traumatic Surgery, Center for Orthopaedic Surgery, Third Affiliated Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Hongjie Luo
- Department of Traumatic Surgery, Center for Orthopaedic Surgery, Third Affiliated Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Sheqiang Chen
- Department of Traumatic Surgery, Center for Orthopaedic Surgery, Third Affiliated Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Haibo Xiang
- Department of Traumatic Surgery, Center for Orthopaedic Surgery, Third Affiliated Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Qiguang Mai
- Department of Traumatic Surgery, Center for Orthopaedic Surgery, Third Affiliated Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhenhua Zhu
- Department of Traumatic Surgery, Center for Orthopaedic Surgery, Third Affiliated Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yuhui Chen
- Department of Traumatic Surgery, Center for Orthopaedic Surgery, Third Affiliated Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhiyong Hou
- Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Wei Chen
- Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Qingan Zhu
- Division of Spine Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - Yingze Zhang
- Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
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Camino-Willhuber G, Urrutia J. Classifications in Brief: The AOSpine Sacral Classification System. Clin Orthop Relat Res 2022; 480:2182-2186. [PMID: 35848956 PMCID: PMC9556097 DOI: 10.1097/corr.0000000000002319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/21/2022] [Indexed: 01/31/2023]
Affiliation(s)
- Gaston Camino-Willhuber
- Institute of Orthopedics “Carlos E. Ottolenghi” Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
- UCI Medical Center, University of California-Irvine, Orange, CA, USA
| | - Julio Urrutia
- Department of Orthopedic Surgery, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
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