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Zhao Y, Ma Y, Wu H, Lian W, Li W, Jiang W. Biomechanical comparative study on external fixators of new configurations in the treatment of Tile C pelvic injury. Sci Rep 2024; 14:9544. [PMID: 38664538 PMCID: PMC11045737 DOI: 10.1038/s41598-024-60341-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 04/22/2024] [Indexed: 04/28/2024] Open
Abstract
To compare the biomechanical properties of several anterior pelvic ring external fixators with two new configurations in the treatment of Tile C pelvic fractures, in order to evaluate the effectiveness of the new configurations and provide a reference for their clinical application. A finite element model of a Tile C pelvic ring injury (unilateral longitudinal sacral fracture and ipsilateral pubic fracture) was constructed. The pelvis was fixed with iliac crest external fixator (IC), anterior inferior iliac spine external fixator (AIIS), combination of IC and AIIS, combination of anterior superior iliac spine external fixator (ASIS) and AIIS, and S1 sacroiliac screw in 5 types of models. The stability indices of the anterior and posterior pelvic rings under vertical longitudinal load, left-right compression load and anterior-posterior shear load were quantified and compared. In the simulated bipedal standing position, the results of the vertical displacement of the midpoint on the upper surface of the sacrum are consistent with the displacement of the posterior rotation angle, and the order from largest to smallest is IC, AIIS, ASIS + AIIS, IC + AIIS and S1 screw. The longitudinal displacement of IC is greater than that of the other models. The displacements of ASIS + AIIS and IC + AIIS are similar and the latter is smaller. In the simulated semi-recumbent position, the vertical displacement and posterior rotation angle displacement of the midpoint on the upper surface of the sacrum are also consistent, ranking from large to small: IC, AIIS, ASIS + AIIS, IC + AIIS and S1 screw. Under the simulated left-right compression load state, the lateral displacements of the highest point of the lateral sacral fracture end are consistent with the highest point of the lateral pubic fracture end, and the order from large to small is S1 screw, IC, AIIS, ASIS + AIIS and IC + AIIS, among which the displacements of S1 screw and IC are larger, and the displacements of ASIS + AIIS and IC + AIIS are similar and smaller than those of other models. The displacements of IC + AIIS are smaller than those of ASIS + AIIS. Under the simulated anterior-posterior shear load condition, the posterior displacements of the highest point of the lateral sacral fracture end and the highest point of the lateral pubic fracture end are also consistent, ranking from large to small: IC, AIIS, ASIS + AIIS, IC + AIIS and S1 screw. Among them, the displacements of IC and AIIS are larger. The displacements of ASIS + AIIS and IC + AIIS are similar and the latter are smaller. For the unstable pelvic injury represented by Tile C pelvic fracture, the biomechanical various stabilities of the combination of IC and AIIS are superior to those of the external fixators of conventional configurations. The biomechanical stabilities of the combination of ASIS and AIIS are also better than those of the external fixators of conventional configurations, and slightly worse than those of the combination of IC and AIIS. Compared with sacroiliac screw and conventional external fixators, the lateral stabilities of IC + AIIS and ASIS + AIIS are particularly prominent.
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Affiliation(s)
- Yong Zhao
- Orthopaedics Department, Yantai Shan Hospital, 91#, Jiefang Road, Yantai, 264001, Shandong, People's Republic of China.
- Yantai Key Laboratory for Repair and Reconstruction of Bone & Joint, Yantai Shan Hospital, 91#, Jiefang Road, Yantai, 264001, Shandong, People's Republic of China.
| | - Yupeng Ma
- Orthopaedics Department, Yantai Shan Hospital, 91#, Jiefang Road, Yantai, 264001, Shandong, People's Republic of China
- Yantai Key Laboratory for Repair and Reconstruction of Bone & Joint, Yantai Shan Hospital, 91#, Jiefang Road, Yantai, 264001, Shandong, People's Republic of China
| | - Hao Wu
- Orthopaedics Department, Yantai Shan Hospital, 91#, Jiefang Road, Yantai, 264001, Shandong, People's Republic of China
- Yantai Key Laboratory for Repair and Reconstruction of Bone & Joint, Yantai Shan Hospital, 91#, Jiefang Road, Yantai, 264001, Shandong, People's Republic of China
| | - Wei Lian
- Yantai Key Laboratory for Repair and Reconstruction of Bone & Joint, Yantai Shan Hospital, 91#, Jiefang Road, Yantai, 264001, Shandong, People's Republic of China
- CT/MR Department, Yantai Shan Hospital, 91#, Jiefang Road, Yantai, 264001, Shandong, People's Republic of China
| | - Wenliang Li
- Orthopaedics Department, Yantai Shan Hospital, 91#, Jiefang Road, Yantai, 264001, Shandong, People's Republic of China
- Yantai Key Laboratory for Repair and Reconstruction of Bone & Joint, Yantai Shan Hospital, 91#, Jiefang Road, Yantai, 264001, Shandong, People's Republic of China
| | - Wenkang Jiang
- Orthopaedics Department, Yantai Shan Hospital, 91#, Jiefang Road, Yantai, 264001, Shandong, People's Republic of China
- Yantai Key Laboratory for Repair and Reconstruction of Bone & Joint, Yantai Shan Hospital, 91#, Jiefang Road, Yantai, 264001, Shandong, People's Republic of China
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Ma Y, Huang T, Liu W, Hong H, Zhao Y, Lin J, Li Y. Biomechanical effects of S1 sacroiliac screws versus S2 sacroiliac screws on sacroiliac screws combined with a lumbar iliac fixation in the treatment of vertical sacral fractures: a biomechanical finite element analysis. BMC Musculoskelet Disord 2023; 24:750. [PMID: 37737168 PMCID: PMC10515427 DOI: 10.1186/s12891-023-06884-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 09/14/2023] [Indexed: 09/23/2023] Open
Abstract
OBJECTIVE To examine the impact of sacroiliac screw position and length on the biomechanical properties of triangular osteosynthesis in treating unilateral vertical sacral fractures and provide a clinical reference. METHODS Unilateral Denis type II sacral fractures were modelled using finite elements to represent Tile C pelvic ring injuries. Six sacroiliac screws were used with iliolumbar fixation patterns to fix the sacral fractures, and the sacral stability, maximum pressure, and stress distribution were compared among the internal fixation modalities. RESULTS The best vertical stability of the internal fixation model was achieved when the S1 segment was fixed with lengthened sacroiliac screws, followed by when the S1 segment was fixed using normal sacroiliac screws. There was no significant difference in vertical stability between the S1 + S2 dual-segment fixation model and the S1-segment fixation model. The maximum pressure under a vertical force of 600 N showed a trend of L5LS1 < L5NS1 < L5LS12 < L5LS2 < L5NS2 < L5NS12. CONCLUSIONS In unilateral vertical sacral fractures (Denis II) treated with triangular osteosynthesis using triangular jointing combined with unilateral iliolumbar + sacroiliac screw fixation, the use of a single lengthened sacroiliac screw for the S1 segment is recommended to achieve the best vertical stability of the sacrum with less maximum compression on the internal fixation components. If it is not possible to apply a lengthened sacroiliac screw, the use of a normal sacroiliac screw for the S1 segment is recommended. Adding an S2 screw does not significantly increase the vertical stability of the sacrum.
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Grants
- No. 81301553 & No. 81641171 National Natural Science Foundation of China
- No. 81301553 & No. 81641171 National Natural Science Foundation of China
- No. BS2013SF015 Distinguished Middle-Aged and Young Scientist Encourage and Reward Foundation of Shandong Province, China
- No. BS2013SF015 Distinguished Middle-Aged and Young Scientist Encourage and Reward Foundation of Shandong Province, China
- No. 2018GSF118064 Shandong Provincial Key R&D Program of China
- No. 2018GSF118064 Shandong Provincial Key R&D Program of China
- No.202104070173 Medical and Health Technology Development Program of Shandong Province, China
- No.202104070173 Medical and Health Technology Development Program of Shandong Province, China
- No. BY2021LCX32 Binzhou Medical University "Clinical + X" Scientific and Technological Innovation Project
- No. BY2021LCX32 Binzhou Medical University "Clinical + X" Scientific and Technological Innovation Project
- No.2021MSGY049&NO.2021YD045&2022YD048 Science & Technology Innovation Development Project of Yantai City, China
- No.2021MSGY049&NO.2021YD045&2022YD048 Science & Technology Innovation Development Project of Yantai City, China
- No.2021MSGY049&NO.2021YD045&2022YD048 Science & Technology Innovation Development Project of Yantai City, China
- No.2021MSGY049&NO.2021YD045&2022YD048 Science & Technology Innovation Development Project of Yantai City, China
- No.2021MSGY049&NO.2021YD045&2022YD048 Science & Technology Innovation Development Project of Yantai City, China
- No.2021MSGY049&NO.2021YD045&2022YD048 Science & Technology Innovation Development Project of Yantai City, China
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Affiliation(s)
- Yupeng Ma
- First Ward of Trauma Orthopaedics, Yantai Shan Hospital, Yantai, Shandong Province, 264003, P.R. China
- Yantai Key Laboratory for Repair and Reconstruction of Bone & Joint, Yantai, Shandong Province, 264003, P.R. China
| | - Tao Huang
- First Ward of Trauma Orthopaedics, Yantai Shan Hospital, Yantai, Shandong Province, 264003, P.R. China
| | - Weiwei Liu
- First Ward of Trauma Orthopaedics, Yantai Shan Hospital, Yantai, Shandong Province, 264003, P.R. China
| | - Huanyu Hong
- First Ward of Trauma Orthopaedics, Yantai Shan Hospital, Yantai, Shandong Province, 264003, P.R. China
| | - Yong Zhao
- Yantai Key Laboratory for Repair and Reconstruction of Bone & Joint, Yantai, Shandong Province, 264003, P.R. China
- Orthopaedics Department, Yantai Shan Hospital, Yantai, Shandong Province, 264003, P.R. China
| | - Jiangtao Lin
- First Ward of Trauma Orthopaedics, Yantai Shan Hospital, Yantai, Shandong Province, 264003, P.R. China
| | - Yu Li
- First Ward of Trauma Orthopaedics, Yantai Shan Hospital, Yantai, Shandong Province, 264003, P.R. China.
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