Parallel analysis of finite element model controlled trial and retrospective case control study on percutaneous internal fixation for vertical sacral fractures.
Parallel analysis of finite element model controlled trial and retrospective case control study on percutaneous internal fixation for vertical sacral fractures.
复制标题
经皮骶骨垂直骨折内固定有限元模型对照试验与回顾性病例对照研究的平行分析
DOI：
10.1186/1471-2474-14-217
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发表时间：
2013-07-23
影响因子：
2.3
通讯作者：
Ding Z
中科院分区：
文献类型：
--
作者：
Chen H;Wu L;Zheng R;Liu Y;Li Y;Ding Z
虽然经皮后环张力带钢板和经皮髂骶螺钉用于固定不稳定的骨盆后环骨折，但两种内固定技术治疗Denis I、II和III型骶骨垂直骨折的生物力学稳定性和相容性尚不清楚。利用第二代中国数字化人“男23号”的CT和MR图像，建立了Denis Ⅰ、Ⅱ、Ⅲ型骶骨垂直骨折合并同侧耻骨上级、下支骨折经皮钢板内固定和经皮螺钉内固定的两组有限元模型。据此，对采用上述两种内固定技术固定的两组临床病例进行回顾性评价，以比较术后效果和功能。采用有限元模型对照试验和病例对照研究进行平行分析。两组患者术后Majeed评分及预后比较差异无统计学意义（P > 0.05）。因此，接骨板固定模型组的最大位移/应力的高值接近螺钉固定模型组的最大位移/应力的高值。然而，在每组模型中进一步模拟Denis I、II和III型骨折发现，接骨板固定模型的生物力学变得越来越稳定和相容，而螺钉固定模型的生物力学保持微小的波动。在治疗Denis III型骨折时，钢板固定模型的骨盆环生物力学效果优于螺钉固定模型。经皮钢板和螺钉固定均适用于Denis I型和II型骶骨垂直骨折;而经皮钢板固定似乎上级经皮螺钉固定Denis III型骶骨垂直骨折。有限元评估的生物力学证据结合临床证据将有助于我们区分垂直骶骨骨折需要钢板或螺钉固定的适应症。
Although percutaneous posterior-ring tension-band metallic plate and percutaneous iliosacral screws are used to fix unstable posterior pelvic ring fractures, the biomechanical stability and compatibility of both internal fixation techniques for the treatment of Denis I, II and III type vertical sacral fractures remain unclear. Using CT and MR images of the second generation of Chinese Digitized Human “male No. 23”, two groups of finite element models were developed for Denis I, II and III type vertical sacral fractures with ipsilateral superior and inferior pubic ramus fractures treated with either a percutaneous metallic plate or a percutaneous screw. Accordingly, two groups of clinical cases that were fixed using the above-mentioned two internal fixation techniques were retrospectively evaluated to compare postoperative effect and function. Parallel analysis was performed with a finite element model controlled trial and a case control study. The difference of the postoperative Majeed standards and outcome rates between two case groups was no statistically significant (P > 0.05). Accordingly, the high values of the maximum displacements/stresses of the plate-fixation model group approximated those of the screw-fixation model group. However, further simulation of Denis I, II and III type fractures in each group of models found that the biomechanics of the plate-fixation models became increasingly stable and compatible, whereas the biomechanics of the screw-fixation models maintained tiny fluctuations. When treating Denis III fractures, the biomechanical effects of the pelvic ring of the plate-fixation model were better than the screw-fixation model. Percutaneous plate and screw fixations are both appropriate for the treatment of Denis I and II type vertical sacral fractures; whereas percutaneous plate fixation appears be superior to percutaneous screw fixation for Denis III type vertical sacral fracture. Biomechanical evidence of finite element evaluations combined with clinical evidence will contribute to our ability to distinguish between indications that require plate or screw fixation for vertical sacral fractures.
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DOI：
10.1016/0376-4583(85)90030-5
发表时间：
1985-01-01
期刊：
SURFACE TECHNOLOGY
影响因子：
--
作者：
SHOCKEY, JS;VONFRAUNHOFER, JA;SELIGSON, D
通讯作者：
SELIGSON, D
DOI：
10.1115/1.2794181
发表时间：
1995-08-01
影响因子：
1.7
作者：
DALSTRA, M;HUISKES, R;VANERNING, L
通讯作者：
VANERNING, L
影响因子：
2.3
作者：
Osterhoff, Georg;Ossendorf, Christian;Werner, Clement M. L.
通讯作者：
Werner, Clement M. L.
影响因子：
2.3
作者：
Griffin, DR;Starr, AJ;Whitlock, S
通讯作者：
Whitlock, S
影响因子：
2.3
作者：
Yinger, K;Scalise, J;Finkemeier, CG
通讯作者：
Finkemeier, CG