Abstract
Objective To compare the mechanical characteristics of lengthened and conventional sacroiliac screws for fixation of unilateral vertical sacral fracture so as to provide evidences for clinic practice.Methods A three-dimensional finite element model of Tile type C pelvic injury (unilateral vertical fracture of the sacrum) was developed.Six different methods for internal fixation with lengthened and conventional sacroiliac screws were performed.Stability of posterior pelvic ring during stance phase and maximum stress on the screws after different fixation methods were measured and compared.Results Mobilization with one lengthened sacroiliac screw at S1 or S2 single-segment provided better biomechanical properties than with one conventional sacroiliac screw at the same segment.Better biomechanical properties were also observed in the bisegmental stabilization with each one lengthened sacroiliac screw compared to bisegmental stabilization with each one conventional sacroiliac screw; in the bisegmental lengthened sacroiliac screw fixation compared to single-segmental lengthened sacroiliac screw fixation; in the bisegmental stabilization with two conventional sacroiliac screws compared to single-segmental stabilization with one conventional sacroiliac screw.No matter which kind of sacroiliac screw was applied,S2 segment stabilization had better biomechanical properties over S1 segment stabilization.Conclusions For unilateral vertical sacral fracture due to Tile type C pelvic ring injury,S1 or S2 lengthened sacroiliac screws should be selected as possible,the best with combination of lengthened sacroiliac screw and conventional sacroiliac screw.Even if lengthened sacroiliac screws cannot be used due to limited conditions,bisegrnental fixation with conventional sacroiliac screws should be considered whenever possible.No matter which kind of sacroiliac screw is applied in single segment fixation,the fixation of S2 segment is the preferred choice. Key words: Sacrum ; Fractures fixation, internal; Biomechanics ; Finite element analysis
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