Abstract
BackgroundTo compare the mechanical characteristics of a percutaneous superior pubic intramedullary screw, percutaneous bridging plate and percutaneous screw-rod system of the anterior ring for the treatment of unilateral vertical pubic fractures to provide a reference for clinical application.MethodsA finite element model of pelvic anterior ring injury (unilateral vertical pubic fracture) was produced. The fractures were fixed with a percutaneous superior pubic intramedullary screw, percutaneous bridging plate and percutaneous screw-rod system of the anterior ring and their combinations in 5 types of models. The fracture stabilities under vertical, bilateral and anterior-posterior load were quantified and compared based on the displacement of the hip joints’ midpoint as quantificational index of fracture stability.ResultsIn the condition of bilateral and anterior-posterior load, the vertical, bilateral and anterior-posterior displacements of the hip joints’ midpoint of different models were significantly different respectively. In general, the displacements of the 5 pelvic anterior ring fixations were ranked from maximum to minimum as follows: bridging plate, pelvic anterior screw-rod system, combination of bridging plate and pelvic anterior screw-rod system, superior pubic intramedullary screw and combination of superior pubic intramedullary screw and pelvic anterior screw-rod system.ConclusionFor the fixation in unilateral pubic fractures of pelvic ring injury, the percutaneous superior pubic intramedullary screw is optimal, the percutaneous pelvic anterior screw-rod system is the second choice, and percutaneous bridging plate ranks the third. The percutaneous pelvic anterior screw-rod system can significantly increase fixation stability of the percutaneous superior pubic intramedullary screw and the percutaneous bridging plate.
Highlights
To compare the mechanical characteristics of a percutaneous superior pubic intramedullary screw, percutaneous bridging plate and percutaneous screw-rod system of the anterior ring for the treatment of unilateral vertical pubic fractures to provide a reference for clinical application
The three-dimensional finite element model of pelvis established by our series of researches was used, and the related parameters were in line with the relevant literature [1, 2, 4]
Comparing the models of single with combined fixations, it demonstrated that the assistant of the anterior ring screw-rod system significantly reduced the displacement of three directions in single bridging plate fixation and sole superior pubic intramedullary screw fixation, and the displacement of the model of superior pubic intramedullary screw combined with anterior ring screw-rod system was the smallest
Summary
To compare the mechanical characteristics of a percutaneous superior pubic intramedullary screw, percutaneous bridging plate and percutaneous screw-rod system of the anterior ring for the treatment of unilateral vertical pubic fractures to provide a reference for clinical application. Due to the distinctive anatomical and physiological characteristics of the pelvis, the pelvic injury has become timeworn when the patient’s general conditions turn to be stable. In this case, the difficulty of reduction and fixation has increased significantly. The deformity is difficult to be corrected, and the risk of intraoperative vascular and neurologic injury significantly increases. This situation is common in Tile C pelvic fracture with poor stability caused by severe injury. In order to minimize the initial mortality rate and late disability rate of pelvic injury, it is essential to perform early, rapid and minimally invasive replacement and internal fixation after an injury and on the precondition that the body can tolerate it
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