Abstract
BackgroundElderly acetabular fractures are one of the more difficult types of fractures to resolve. For patients at this age, the more common type of fracture is comminuted. How to better fix this type of fracture has always been an issue of concern. This study was performed to observe the mechanical properties of different internal fixation methods used in treating elderly acetabular fracture patients.MethodsA model of a comminuted acetabular fracture in osteoporosis was established, consisting of an anterior column–posterior hemitransverse fracture with disruption of the quadrilateral surface. Fixation of the acetabular fracture model using a reconstruction plate and Union Plates was simulated. For the different internal fixation methods, static and transient modal analyses were performed under different loads, with an action time of 0.21 s and an analysis time of 0.7 s. The stress of the model was observed in the static analysis, and the displacement of the nodes and the entire model in the U1 direction was observed in the transient modal analysis.ResultsIn the static analysis, the stress of the osteoporosis model, the suprapectineal pelvic reconstruction plate model, the infrapectineal quadrilateral surface buttress plate model, and the suprapectineal quadrilateral surface buttress plate model were 42.62 MPa, 37.49 MPa, 44.39 MPa, and 46.15 MPa, respectively. The stress was mainly distributed near the suprapubic branch. The corresponding displacement in the U1 direction was 0.1500 mm, 0.1020 mm, 0.0836 mm, and 0.0990 mm, respectively. In the transient modal analysis, there was a significant difference in displacement between the different models (P < 0.05). When different loads were applied with the same fixation method, there was no significant difference in model displacement (P > 0.05).ConclusionStatic and transient modal analyses show that the infrapectineal quadrilateral surface buttress plate or the suprapectineal quadrilateral surface buttress plate has an advantage in maintaining the stability of fracture fragments when fixing comminuted acetabular fractures in elderly individuals. The infrapectineal quadrilateral surface buttress plate also presents better biomechanical results.
Highlights
Acetabular fractures in elderly individuals are often accompanied by poor bone conditions caused by osteoporosis [1]
The stress was distributed in the ipsilateral sacroiliac joint of the pelvis in the osteoporosis model (OM), in close proximity to the suprapubic branch above the obturator in the suprapectineal pelvic reconstruction plate (SPRP) model, at the suprapubic branch in the Infrapectineal quadrilateral surface buttress plate (IQSBP) model, and at the internal fixation of the suprapubic branch at the junction of the acetabular quadrilateral surfaces in the Suprapectineal quadrilateral surface buttress plate (SQSBP) model (Fig. 3)
In the static and transient modal analyses of loads applied to the same model, statistical analysis yielded a P value of 0.1145 (P > 0.05), indicating no significant difference in the displacement in the U1 direction under different loads applied to the same model
Summary
Acetabular fractures in elderly individuals are often accompanied by poor bone conditions caused by osteoporosis [1]. Achieving strong fixation of comminuted fractures in the quadrilateral surface of the acetabulum is a challenge in pelvic surgery. Lin et al [7] advocated the use of 3D-printed personalized titanium alloy plates to fix acetabular fractures, which can be used to achieve good fixation of comminuted acetabular fractures. Our team invented a plate for achieving strong fixation of acetabular fractures, filling this gap, and used sawbones to perform related mechanical tests, which showed good results [8]. Acetabular fractures are one of the more difficult types of fractures to resolve For patients at this age, the more common type of fracture is comminuted. This study was performed to observe the mechanical properties of different internal fixation methods used in treating elderly acetabular fracture patients
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