Comparison of Biomechanical Performance of Five Different Treatment Approaches for Fixing Posterior Pelvic Ring Injury
| Autor: | Yiqian He, Yongtao Lu, Li Yu, Ruifei Peng, Weiteng Li, Zhuoyue Yang |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male musculoskeletal diseases Medicine (General) Article Subject medicine.medical_treatment Finite Element Analysis Biomedical Engineering Health Informatics 03 medical and health sciences Fixation (surgical) Fracture Fixation Internal Fractures Bone 0302 clinical medicine R5-920 Fracture fixation Bone plate Medical technology Medicine Internal fixation Humans 030212 general & internal medicine R855-855.5 Pelvic Bones Pelvis Orthodontics Sacroiliac joint 030222 orthopedics Osteosynthesis business.industry Sacrum Biomechanical Phenomena medicine.anatomical_structure Surgical Procedures Operative Surgery business Bone Plates Biotechnology Research Article |
| Zdroj: | Journal of Healthcare Engineering, Vol 2020 (2020) Journal of Healthcare Engineering |
| ISSN: | 2040-2309 2040-2295 |
| Popis: | Background. A large number of pelvic injuries are seriously unstable, with mortality rates reaching 19%. Approximately 60% of pelvic injuries are related to the posterior pelvic ring. However, the selection of a fixation method for a posterior pelvic ring injury remains a challenging problem for orthopedic surgeons. The aim of the present study is to investigate the biomechanical performance of five different fixation approaches for posterior pelvic ring injury and thus provide guidance on the choice of treatment approach in a clinical setting. Methods. A finite element (FE) model, including the L3-L5 lumbar vertebrae, sacrum, and full pelvis, was created from CT images of a healthy adult. Tile B and Tile C types of pelvic fractures were created in the model. Five different fixation methods for fixing the posterior ring injury (PRI) were simulated: TA1 (conservative treatment), TA2 (S1 screw fixation), TA3 (S1 + S2 screw fixation), TA4 (plate fixation), and TA5 (modified triangular osteosynthesis). Based on the fixation status (fixed or nonfixed) of the anterior ring and the fixation method for PRI, 20 different FE models were created. An upright standing loading scenario was simulated, and the resultant displacements at the sacroiliac joint were compared between different models. Results. When TA5 was applied, the resultant displacements at the sacroiliac joint were the smallest (1.5 mm, 1.6 mm, 1.6 mm, and 1.7 mm) for all the injury cases. The displacements induced by TA3 and TA2 were similar to those induced by TA5. TA4 led to larger displacements at the sacroiliac joint (2.3 mm, 2.4 mm, 4.8 mm, and 4.9 mm), and TA1 was the worst case (3.1 mm, 3.2 mm, 6.3 mm, and 6.5 mm). Conclusions. The best internal fixation method for PRI is the triangular osteosynthesis approach (TA5), followed by S1 + S2 screw fixation (TA3), S1 screw fixation (TA2), and plate fixation (TA4). |
| Databáze: | OpenAIRE |
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