Biomechanical comparison of posterior pelvic ring fixation
Biomechanical comparison of posterior pelvic ring fixation
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DOI：
10.1097/00005131-200308000-00002
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发表时间：
2003-08-01
影响因子：
2.3
通讯作者：
Finkemeier, CG
中科院分区：
文献类型：
--
作者：
Yinger, K;Scalise, J;Finkemeier, CG
目的：目的：确定各种骨盆后环内固定方法的相对刚度。设计：模拟OTA 61 - 0.2，a2骨折模型（单侧骶髂关节断裂和耻骨联合塌陷）的单腿站立载荷。地点：骨科生物力学实验室。结果变量：耻骨联合间隙，骶髂关节帽。方法：在6个硬塑料骨盆模型上分别采用9种不同的骨盆后环固定方法进行试验。耻骨联合用钢板固定。结果：所有数据均标准化为后路单根骶髂螺钉固定的数值。根据固定的相对刚度，固定类型可分为三类：对于骶髂关节间隙，第1组-固定刚度0.8及以上（刚度最小）包括单个髂骶螺钉（条件A和J），隔离张力带板（条件F）和两个骶骨杆（条件H）;第2组-固定刚度0.6 - 0.8（中等刚度）包括张力带钢板和髂骶螺钉（条件E），一个或两个骶骨棒与髂骶螺钉组合（条件G和I）;第3组-固定刚度0.6及以下（最大刚度）包括两个骶髂前路钢板（条件D）、两个髂骶螺钉（条件B）以及两个骶髂前路钢板和一个髂骶螺钉（条件C）。对于骶髂关节旋转，第1组-固定刚度0.8及以上包括单个髂骶螺钉（条件A和J），两块骶髂前板（条件D），张力带钢板单独使用或与髂骶螺钉联合使用（条件E和F），和两个骶骨杆（条件H）;组2-固定刚度0.6 - 0.8（中度不稳定）包括一个或两个骶骨棒与髂骶螺钉组合（条件G和1）;组3-固定刚度0.6及以下（最硬固定）由两个髂骶螺钉组成（条件13）和两个骶髂前路钢板和一个骶髂螺钉（条件C）.讨论：在最大不稳定性条件下，样本之间的材料特性相似，可以证明后骨盆环固定的刚度差异。选择使用哪种方法是多因素的。
Objective: To determine relative stiffness of various methods of posterior pelvic ring internal fixation.Design: Simulated single leg stance loading of OTA 61-0.2, a2 fracture model (unilateral sacroiliac joint disruption and pubic symphysis diastasis).Setting: Orthopaedic biomechanic laboratory.Outcome Variables: Pubic symphysis gapping, sacroiliac joint capping. hemipelvis coronal plane rotation.Methods: Nine different posterior pelvic ring fixation methods were tested on each of six hard plastic pelvic models. Pubic symphysis Was plated. The pelvic ring was loaded to 1000N.Results: All data were normalized to values obtained with posterior fixation with a single itiosacral screw. The types of fixation could be grouped into three categories based on relative stiffness of fixation: For sacroiliac joint gapping, group 1-fixation stiffness 0.8 and above (least stiff) includes a single iliosacral screw (conditions A and J), an isolated tension band plate (condition F), and two sacral bars (condition H); group 2-fixation stiffness 0.6 to 0.8 (intermediate stiffness) includes a tension band plate and an iliosacral screw (condition E), one or two sacral bars in combination with an iliosacral screw (conditions G and I); group 3-fixation stiffness 0.6 and below (greatest stiffness) includes two anterior sacroiliac plates (condition D), two iliosacral screws (condition B), and two anterior sacroiliac plates and an iliosacral screw (condition C). For sacroiliac joint rotation, group 1-fixation stiffness 0.8 and above includes a single iliosacral screw (conditions A and J), two anterior sacroiliac plates (condition D), a tension band plate in isolation or in combination with an iliosacral screw (conditions E and F), and two sacral bars (condition H); group 2-fixation stiffness 0.6 to 0.8 (intermediate level of instability) includes either one or two sacral bars in combination with an iliosacral screw (conditions G and 1); group 3-fixation stiffness 0.6 and below (stiffest fixation) consists of two iliosacral screws (condition 13) and two anterior sacroiliac plates and an iliosacral screw (condition C).Discussion: Under conditions of maximal instability with similar material properties between specimens, differences in stiffness of posterior pelvic ring fixation can be demonstrated. The choice of which method to use is multifactorial.