Posterior wall acetabular fracture fixation: A mechanical analysis of fixation methods
| Autor: | J L Cunningham, F Pease, Mehool R. Acharya, A J Stevenson, O Sabri, T. J. S. Chesser, Anthony J. Ward |
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| Rok vydání: | 2019 |
| Předmět: |
Models
Anatomic Bone Screws 03 medical and health sciences Fixation (surgical) Fracture Fixation Internal Fractures Bone 0302 clinical medicine Posterior wall lcsh:Orthopedic surgery medicine Humans 030212 general & internal medicine Orthodontics 030222 orthopedics business.industry Acetabular fracture Stiffness Acetabulum medicine.disease Fixation method Biomechanical Phenomena Transverse plane lcsh:RD701-811 Surgery medicine.symptom Maximum displacement business Bone Plates |
| Zdroj: | Journal of Orthopaedic Surgery, Vol 27 (2019) |
| ISSN: | 2309-4990 |
| Popis: | Stable, anatomical fixation of acetabular fractures gives the best chance of successful outcome, while penetration of the acetabular articular surface with screws is associated with poor outcomes. Spring plates are an alternative to interfragmentary lag screws when penetration is a concern. A mechanical study comparing fracture stability and construct stiffness of three fixation methods for posterior wall acetabular fractures with transverse comminutions was performed. The three fixation methods tested were a posterior wall rim plate, a posterior wall buttress plate with separate lag screws and a posterior wall plate with two spring plates. Nine samples were tested, three for each fixation method. Two-dimensional motion analysis was used to measure fracture fragment displacement and construct stiffness. After two 6000 cycle-loading protocols, to a maximum 1.5 kN, the mean fracture displacement was 0.154 mm for the rim plate model, 0.326 mm for the buttress plate and 0.254 mm for the spring plate model. Mean maximum displacement was significantly less for the rim plate fixation than the buttress plate ( p = 0.015) and spring plate fixation ( p = 0.02). The rim plate was the stiffest construct 10,962 N/mm, followed by the spring plate model 5637 N/mm and the buttress plate model 4882 N/mm. Based on data obtained in this study, where possible a rim plate with interfragmentary lag screws should be used for isolated posterior wall fractures as this is the stiffest and most stable construct. When this method is not possible, spring plate fixation is a safe and a superior alternative to a posterior buttress plate method. |
| Databáze: | OpenAIRE |
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