Is a Washer a Mandatory Component in Young Trauma Patients with S1-S2 Iliosacral Screw Fixation of Posterior Pelvis Ring Injuries? A Biomechanical Study
<i>Background and purpose</i>: Cannulated screws are standard implants for percutaneous fixa-tion of posterior pelvis ring injuries. The choice of whether to use these screws in combination with a washer is still undecided. The aim of this study was to evaluate the biomechanical competen...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-07-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/8/1379 |
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| author | Till Berk Ivan Zderic Peter Schwarzenberg Torsten Pastor Sascha Halvachizadeh Geoff Richards Boyko Gueorguiev Hans-Christoph Pape |
| author_facet | Till Berk Ivan Zderic Peter Schwarzenberg Torsten Pastor Sascha Halvachizadeh Geoff Richards Boyko Gueorguiev Hans-Christoph Pape |
| author_sort | Till Berk |
| collection | DOAJ |
| description | <i>Background and purpose</i>: Cannulated screws are standard implants for percutaneous fixa-tion of posterior pelvis ring injuries. The choice of whether to use these screws in combination with a washer is still undecided. The aim of this study was to evaluate the biomechanical competence of S1-S2 sacroiliac (SI) screw fixation with and without using a washer across three different screw designs. <i>Material and Methods</i>: Twenty-four composite pelvises were used and an SI joint injury type APC III according to the Young and Burgess classification was simulated. Fixation of the posterior pelvis ring was performed using either partially threaded short screws, fully threaded short screws, or fully threaded long transsacral screws. Biomechanical testing was performed under progressively increasing cyclic loading until failure, with monitoring of the intersegmental and bone-implant movements via motion tracking. <i>Results</i>: The number of cycles to failure and the corresponding load at failure (N) were significantly higher for the fully threaded short screws with a washer (3972 ± 600/398.6 ± 30.0) versus its counterpart without a washer (2993 ± 527/349.7 ± 26.4), <i>p</i> = 0.026. In contrast, these two parameters did not reveal any significant differences when comparing fixations with and without a washer using either partially threaded short of fully threaded long transsacral screws, <i>p</i> ≥ 0.359. <i>Conclusions</i>: From a biomechanical perspective, a washer could be optional when using partially threaded short or fully threaded long transsacral S1-S2 screws for treatment of posterior pelvis ring injuries in young trauma patients. Yet, the omission of the washer in fully threaded short screws could lead to a significant diminished biomechanical stability. |
| first_indexed | 2024-03-10T23:45:26Z |
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| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T23:45:26Z |
| publishDate | 2023-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-45904ba52f104db7a266ed5f95e28fef2023-11-19T02:05:18ZengMDPI AGMedicina1010-660X1648-91442023-07-01598137910.3390/medicina59081379Is a Washer a Mandatory Component in Young Trauma Patients with S1-S2 Iliosacral Screw Fixation of Posterior Pelvis Ring Injuries? A Biomechanical StudyTill Berk0Ivan Zderic1Peter Schwarzenberg2Torsten Pastor3Sascha Halvachizadeh4Geoff Richards5Boyko Gueorguiev6Hans-Christoph Pape7AO Research Institute Davos, Clavadelerstrasse 8, 7270 Davos, SwitzerlandAO Research Institute Davos, Clavadelerstrasse 8, 7270 Davos, SwitzerlandAO Research Institute Davos, Clavadelerstrasse 8, 7270 Davos, SwitzerlandDepartment of Orthopaedic and Trauma Surgery, Cantonal Hospital Lucerne, 6000 Lucerne, SwitzerlandDepartment of Trauma, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, SwitzerlandAO Research Institute Davos, Clavadelerstrasse 8, 7270 Davos, SwitzerlandAO Research Institute Davos, Clavadelerstrasse 8, 7270 Davos, SwitzerlandDepartment of Trauma, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland<i>Background and purpose</i>: Cannulated screws are standard implants for percutaneous fixa-tion of posterior pelvis ring injuries. The choice of whether to use these screws in combination with a washer is still undecided. The aim of this study was to evaluate the biomechanical competence of S1-S2 sacroiliac (SI) screw fixation with and without using a washer across three different screw designs. <i>Material and Methods</i>: Twenty-four composite pelvises were used and an SI joint injury type APC III according to the Young and Burgess classification was simulated. Fixation of the posterior pelvis ring was performed using either partially threaded short screws, fully threaded short screws, or fully threaded long transsacral screws. Biomechanical testing was performed under progressively increasing cyclic loading until failure, with monitoring of the intersegmental and bone-implant movements via motion tracking. <i>Results</i>: The number of cycles to failure and the corresponding load at failure (N) were significantly higher for the fully threaded short screws with a washer (3972 ± 600/398.6 ± 30.0) versus its counterpart without a washer (2993 ± 527/349.7 ± 26.4), <i>p</i> = 0.026. In contrast, these two parameters did not reveal any significant differences when comparing fixations with and without a washer using either partially threaded short of fully threaded long transsacral screws, <i>p</i> ≥ 0.359. <i>Conclusions</i>: From a biomechanical perspective, a washer could be optional when using partially threaded short or fully threaded long transsacral S1-S2 screws for treatment of posterior pelvis ring injuries in young trauma patients. Yet, the omission of the washer in fully threaded short screws could lead to a significant diminished biomechanical stability.https://www.mdpi.com/1648-9144/59/8/1379biomechanicsmotion trackingposterior pelvis ring injuryS1-S2 sacroiliac screw fixationsynthetic pelvic bone modeltranssacral fixation |
| spellingShingle | Till Berk Ivan Zderic Peter Schwarzenberg Torsten Pastor Sascha Halvachizadeh Geoff Richards Boyko Gueorguiev Hans-Christoph Pape Is a Washer a Mandatory Component in Young Trauma Patients with S1-S2 Iliosacral Screw Fixation of Posterior Pelvis Ring Injuries? A Biomechanical Study Medicina biomechanics motion tracking posterior pelvis ring injury S1-S2 sacroiliac screw fixation synthetic pelvic bone model transsacral fixation |
| title | Is a Washer a Mandatory Component in Young Trauma Patients with S1-S2 Iliosacral Screw Fixation of Posterior Pelvis Ring Injuries? A Biomechanical Study |
| title_full | Is a Washer a Mandatory Component in Young Trauma Patients with S1-S2 Iliosacral Screw Fixation of Posterior Pelvis Ring Injuries? A Biomechanical Study |
| title_fullStr | Is a Washer a Mandatory Component in Young Trauma Patients with S1-S2 Iliosacral Screw Fixation of Posterior Pelvis Ring Injuries? A Biomechanical Study |
| title_full_unstemmed | Is a Washer a Mandatory Component in Young Trauma Patients with S1-S2 Iliosacral Screw Fixation of Posterior Pelvis Ring Injuries? A Biomechanical Study |
| title_short | Is a Washer a Mandatory Component in Young Trauma Patients with S1-S2 Iliosacral Screw Fixation of Posterior Pelvis Ring Injuries? A Biomechanical Study |
| title_sort | is a washer a mandatory component in young trauma patients with s1 s2 iliosacral screw fixation of posterior pelvis ring injuries a biomechanical study |
| topic | biomechanics motion tracking posterior pelvis ring injury S1-S2 sacroiliac screw fixation synthetic pelvic bone model transsacral fixation |
| url | https://www.mdpi.com/1648-9144/59/8/1379 |
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