S2-alar-iliac screw and S1 pedicle screw fixation for the treatment of non-osteoporotic sacral fractures: a finite element study
Abstract Background Five different sacral fracture fixation methods were compared using finite element (FE) analysis to study their biomechanical characteristics. Methods Denis type I sacral fractures were created by FE modeling. Five different fixation methods for the posterior pelvic ring were sim...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-10-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-021-02805-8 |
| _version_ | 1798041032649080832 |
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| author | Jianxiong Zheng Xiaoreng Feng Jie Xiang Fei Liu Frankie K. L. Leung Bin Chen |
| author_facet | Jianxiong Zheng Xiaoreng Feng Jie Xiang Fei Liu Frankie K. L. Leung Bin Chen |
| author_sort | Jianxiong Zheng |
| collection | DOAJ |
| description | Abstract Background Five different sacral fracture fixation methods were compared using finite element (FE) analysis to study their biomechanical characteristics. Methods Denis type I sacral fractures were created by FE modeling. Five different fixation methods for the posterior pelvic ring were simulated: sacroiliac screw (SIS), lumbopelvic fixation (LPF), transiliac internal fixator (TIFI), S2-alar-iliac (S2AI) screw and S1 pedicle screw fixation (S2AI-S1) and S2AI screw and contralateral S1 pedicle screw fixation (S2AI-CS1). Four different loading methods were implemented in sequence to simulate the force in standing, flexion, right bending and left twisting, respectively. Vertical stiffness, relative displacement and change in relative displacement were recorded and analyzed. Results As predicted by the FE model, the vertical stiffness of the five groups in descending order was S2AI-S1, SIS, S2AI-CS1, LPF and TIFI. In terms of relative displacement, groups S2AI-S1 and S2AI-CS1 displayed a lower mean relative displacement, although group S2AI-CS1 exhibited greater displacement in the upper sacrum than group S2AI-S1. Group SIS displayed a moderate mean relative displacement, although the displacement of the upper sacrum was smaller than the corresponding displacement in group S2AI-CS1, while groups LPF and TIFI displayed larger mean relative displacements. Finally, in terms of change in relative displacement, groups TIFI and LPF displayed the greatest fluctuations in their motion, while groups SIS, S2AI-S1 and S2AI-CS1 displayed smaller fluctuations. Conclusion Compared with SIS, unilateral LPF and TIFI, group S2AI-S1 displayed the greatest biomechanical stability of the Denis type I sacral fracture FE models. When the S1 pedicle screw insertion point on the affected side is damaged, S2AI-CS1 can be used as an appropriate alternative to S2AI-S1. |
| first_indexed | 2024-04-11T22:15:50Z |
| format | Article |
| id | doaj.art-dc30c43b3a404e309f2f449114b87b70 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T22:15:50Z |
| publishDate | 2021-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-dc30c43b3a404e309f2f449114b87b702022-12-22T04:00:24ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-10-0116111010.1186/s13018-021-02805-8S2-alar-iliac screw and S1 pedicle screw fixation for the treatment of non-osteoporotic sacral fractures: a finite element studyJianxiong Zheng0Xiaoreng Feng1Jie Xiang2Fei Liu3Frankie K. L. Leung4Bin Chen5Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical UniversityDivision of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical UniversityDivision of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical UniversityDivision of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical UniversityDepartment of Orthopaedics and Traumatology, Queen Mary Hospital, The University of Hong KongDivision of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical UniversityAbstract Background Five different sacral fracture fixation methods were compared using finite element (FE) analysis to study their biomechanical characteristics. Methods Denis type I sacral fractures were created by FE modeling. Five different fixation methods for the posterior pelvic ring were simulated: sacroiliac screw (SIS), lumbopelvic fixation (LPF), transiliac internal fixator (TIFI), S2-alar-iliac (S2AI) screw and S1 pedicle screw fixation (S2AI-S1) and S2AI screw and contralateral S1 pedicle screw fixation (S2AI-CS1). Four different loading methods were implemented in sequence to simulate the force in standing, flexion, right bending and left twisting, respectively. Vertical stiffness, relative displacement and change in relative displacement were recorded and analyzed. Results As predicted by the FE model, the vertical stiffness of the five groups in descending order was S2AI-S1, SIS, S2AI-CS1, LPF and TIFI. In terms of relative displacement, groups S2AI-S1 and S2AI-CS1 displayed a lower mean relative displacement, although group S2AI-CS1 exhibited greater displacement in the upper sacrum than group S2AI-S1. Group SIS displayed a moderate mean relative displacement, although the displacement of the upper sacrum was smaller than the corresponding displacement in group S2AI-CS1, while groups LPF and TIFI displayed larger mean relative displacements. Finally, in terms of change in relative displacement, groups TIFI and LPF displayed the greatest fluctuations in their motion, while groups SIS, S2AI-S1 and S2AI-CS1 displayed smaller fluctuations. Conclusion Compared with SIS, unilateral LPF and TIFI, group S2AI-S1 displayed the greatest biomechanical stability of the Denis type I sacral fracture FE models. When the S1 pedicle screw insertion point on the affected side is damaged, S2AI-CS1 can be used as an appropriate alternative to S2AI-S1.https://doi.org/10.1186/s13018-021-02805-8S2-alar-iliac screwSacral fracturePelvic ring injurySacropelvic fixationBiomechanics |
| spellingShingle | Jianxiong Zheng Xiaoreng Feng Jie Xiang Fei Liu Frankie K. L. Leung Bin Chen S2-alar-iliac screw and S1 pedicle screw fixation for the treatment of non-osteoporotic sacral fractures: a finite element study Journal of Orthopaedic Surgery and Research S2-alar-iliac screw Sacral fracture Pelvic ring injury Sacropelvic fixation Biomechanics |
| title | S2-alar-iliac screw and S1 pedicle screw fixation for the treatment of non-osteoporotic sacral fractures: a finite element study |
| title_full | S2-alar-iliac screw and S1 pedicle screw fixation for the treatment of non-osteoporotic sacral fractures: a finite element study |
| title_fullStr | S2-alar-iliac screw and S1 pedicle screw fixation for the treatment of non-osteoporotic sacral fractures: a finite element study |
| title_full_unstemmed | S2-alar-iliac screw and S1 pedicle screw fixation for the treatment of non-osteoporotic sacral fractures: a finite element study |
| title_short | S2-alar-iliac screw and S1 pedicle screw fixation for the treatment of non-osteoporotic sacral fractures: a finite element study |
| title_sort | s2 alar iliac screw and s1 pedicle screw fixation for the treatment of non osteoporotic sacral fractures a finite element study |
| topic | S2-alar-iliac screw Sacral fracture Pelvic ring injury Sacropelvic fixation Biomechanics |
| url | https://doi.org/10.1186/s13018-021-02805-8 |
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