Biomechanical Comparison of Five Fixation Techniques for Unstable Fragility Fractures of the Pelvic Ring
Background: Incidence of pelvic ring fractures has increased over the past four decades, especially after low-impact trauma—classified as fragility fractures of the pelvis (FFP). To date, there is a lack of biomechanical evidence for the superiority of one existing fixation technique over another. A...
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MDPI AG
2021-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/11/2326 |
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| author | Moritz F. Lodde J. Christoph Katthagen Clemens O. Schopper Ivan Zderic Geoff Richards Boyko Gueorguiev Michael J. Raschke René Hartensuer |
| author_facet | Moritz F. Lodde J. Christoph Katthagen Clemens O. Schopper Ivan Zderic Geoff Richards Boyko Gueorguiev Michael J. Raschke René Hartensuer |
| author_sort | Moritz F. Lodde |
| collection | DOAJ |
| description | Background: Incidence of pelvic ring fractures has increased over the past four decades, especially after low-impact trauma—classified as fragility fractures of the pelvis (FFP). To date, there is a lack of biomechanical evidence for the superiority of one existing fixation technique over another. An FFP type IIc was simulated in 50 artificial pelvises, assigned to 5 study groups: Sacroiliac (SI) screw, SI screw plus supra-acetabular external fixator, SI screw plus plate, SI screw plus retrograde transpubic screw, or S1/S2 ala–ilium screws. The specimens were tested under progressively increasing cyclic loading. Axial stiffness and cycles to failure were analysed. Displacement at the fracture sites was evaluated, having been continuously captured via motion tracking. Results: Fixation with SI screw plus plate and SI screw plus retrograde transpubic screw led to higher stability than the other tested techniques. The S1/S2 ala–ilium screws were more stable than the SI screw or the SI screw plus external fixator. Conclusions: In cases with displaced fractures, open reduction and plate fixation provides the highest stability, whereas in cases where minimally invasive techniques are applicable, a retrograde transpubic screw or S1/S2 ala–ilium screws can be considered as successful alternative treatment options. |
| first_indexed | 2024-03-10T11:00:13Z |
| format | Article |
| id | doaj.art-21b4eb27e0ac48f79f8351b21dc839ec |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T11:00:13Z |
| publishDate | 2021-05-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-21b4eb27e0ac48f79f8351b21dc839ec2023-11-21T21:31:07ZengMDPI AGJournal of Clinical Medicine2077-03832021-05-011011232610.3390/jcm10112326Biomechanical Comparison of Five Fixation Techniques for Unstable Fragility Fractures of the Pelvic RingMoritz F. Lodde0J. Christoph Katthagen1Clemens O. Schopper2Ivan Zderic3Geoff Richards4Boyko Gueorguiev5Michael J. Raschke6René Hartensuer7AO Research Institute Davos, Clavadelerstrasse 8, 7270 Davos, SwitzerlandDepartment for Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus 1, Building W1, Waldeyerstraße 1, 48149 Münster, GermanyAO Research Institute Davos, Clavadelerstrasse 8, 7270 Davos, SwitzerlandAO Research Institute Davos, Clavadelerstrasse 8, 7270 Davos, SwitzerlandAO Research Institute Davos, Clavadelerstrasse 8, 7270 Davos, SwitzerlandAO Research Institute Davos, Clavadelerstrasse 8, 7270 Davos, SwitzerlandDepartment for Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus 1, Building W1, Waldeyerstraße 1, 48149 Münster, GermanyDepartment for Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus 1, Building W1, Waldeyerstraße 1, 48149 Münster, GermanyBackground: Incidence of pelvic ring fractures has increased over the past four decades, especially after low-impact trauma—classified as fragility fractures of the pelvis (FFP). To date, there is a lack of biomechanical evidence for the superiority of one existing fixation technique over another. An FFP type IIc was simulated in 50 artificial pelvises, assigned to 5 study groups: Sacroiliac (SI) screw, SI screw plus supra-acetabular external fixator, SI screw plus plate, SI screw plus retrograde transpubic screw, or S1/S2 ala–ilium screws. The specimens were tested under progressively increasing cyclic loading. Axial stiffness and cycles to failure were analysed. Displacement at the fracture sites was evaluated, having been continuously captured via motion tracking. Results: Fixation with SI screw plus plate and SI screw plus retrograde transpubic screw led to higher stability than the other tested techniques. The S1/S2 ala–ilium screws were more stable than the SI screw or the SI screw plus external fixator. Conclusions: In cases with displaced fractures, open reduction and plate fixation provides the highest stability, whereas in cases where minimally invasive techniques are applicable, a retrograde transpubic screw or S1/S2 ala–ilium screws can be considered as successful alternative treatment options.https://www.mdpi.com/2077-0383/10/11/2326pelvic ring fractureexternal fixatorretrograde transpubic screwS1/S2 ala–ilium screwsbiomechanics |
| spellingShingle | Moritz F. Lodde J. Christoph Katthagen Clemens O. Schopper Ivan Zderic Geoff Richards Boyko Gueorguiev Michael J. Raschke René Hartensuer Biomechanical Comparison of Five Fixation Techniques for Unstable Fragility Fractures of the Pelvic Ring Journal of Clinical Medicine pelvic ring fracture external fixator retrograde transpubic screw S1/S2 ala–ilium screws biomechanics |
| title | Biomechanical Comparison of Five Fixation Techniques for Unstable Fragility Fractures of the Pelvic Ring |
| title_full | Biomechanical Comparison of Five Fixation Techniques for Unstable Fragility Fractures of the Pelvic Ring |
| title_fullStr | Biomechanical Comparison of Five Fixation Techniques for Unstable Fragility Fractures of the Pelvic Ring |
| title_full_unstemmed | Biomechanical Comparison of Five Fixation Techniques for Unstable Fragility Fractures of the Pelvic Ring |
| title_short | Biomechanical Comparison of Five Fixation Techniques for Unstable Fragility Fractures of the Pelvic Ring |
| title_sort | biomechanical comparison of five fixation techniques for unstable fragility fractures of the pelvic ring |
| topic | pelvic ring fracture external fixator retrograde transpubic screw S1/S2 ala–ilium screws biomechanics |
| url | https://www.mdpi.com/2077-0383/10/11/2326 |
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