Do we need to fix the anterior fracture component in insufficiency fractures of the pelvis? A biomechanical comparison on an FFP type IIIc fracture in an osteoporotic pelvic bone model.

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License: CC BY 4.0
Serval ID
serval:BIB_829F3CB9692F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Do we need to fix the anterior fracture component in insufficiency fractures of the pelvis? A biomechanical comparison on an FFP type IIIc fracture in an osteoporotic pelvic bone model.
Journal
Injury
Author(s)
Arand C., Mehler D., Sauer A., Hartung C., Gercek E., Rommens P.M., Wagner D.
ISSN
1879-0267 (Electronic)
ISSN-L
0020-1383
Publication state
Published
Issued date
12/2023
Peer-reviewed
Oui
Volume
54
Number
12
Pages
111096
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
There is a growing understanding of the specific characteristics of insufficiency fractures of the pelvis and of general requirements for the treatment of affected patients with focus on early mobilization and effective pain reduction as the main goals of therapy. While there is consensus on the significance of achieving stability of the dorsal pelvic ring structures there is still an open discussion about the potential benefits of additional stabilization of an anterior fracture component. Within a biomechanical test setup, two established methods of dorsal fracture fixation were tested under axial loading (25-1200 N; 1000 test cycles) on an explicit osteoporotic bone model (n = 32) with a standardized FFP type IIIc fracture with and without additional fixation of the anterior fracture component. Dorsal fixation was performed with and long and a short 7.3 mm cannulated screw in S1 in one group (n = 16), and a trans sacral bar with an additional short 7.3 mm cannulated screw in S1 in the other group (n = 16). Half of the samples received a 7.3 mm cannulated retrograde transpubic screw for anterior fixation. The fixation with the trans sacral bar and the additional anterior screw fixation showed the highest rate of stability (p = 0.0014), followed by the double SI-screw fixation with stabilization of the anterior fracture (p = 0.0002). During testing, we observed the occurrence of new sacral fractures contralateral to the initial fracture in 22/32 samples. The results let us assume that stabilization of an additional anterior fracture component relevantly improves the stability of the entire ring construct and might prevent failure of the dorsal stabilization or further fracture progression.
Keywords
Humans, Fracture Fixation, Internal/methods, Fractures, Stress, Fractures, Bone/surgery, Pelvic Bones/surgery, Sacrum/surgery, Pelvis, Biomechanical Phenomena, Osteoporotic Fractures/surgery, Biomechanical evaluation, Fragility fracture, Insufficiency fracture, Minimal invasive stabilization, Pelvic ring fracture
Pubmed
Web of science
Create date
19/10/2023 16:25
Last modification date
13/01/2024 8:08
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