Biomechanical study of three kinds of internal fixation for the treatment of sacroiliac joint disruption using biomechan
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RESEARCH ARTICLE
Open Access
Biomechanical study of three kinds of internal fixation for the treatment of sacroiliac joint disruption using biomechanical test and finite element analysis Tao Wu1, Xuejiao Ren2, Yunwei Cui3, Xiaodong Cheng3, Shuo Peng1, Zhiyong Hou3 and Yongtai Han1*
Abstract Background: To compare the stability of sacroiliac joint disruption fixed with three kinds of internal fixation using both biomechanical test and finite element analysis. Methods: Five embalmed specimens of an adult were used. The symphysis pubis rupture and left sacroiliac joint disruption were created. The symphysis pubis was stabilized with a five-hole plate. The sacroiliac joint disruption was fixed with three kinds of internal fixation in a randomized design. Displacements of the whole specimen and shifts in the gap were recorded. Three-dimensional finite element models of the pelvis, the pelvis with symphysis pubis rupture and left sacroiliac joint disruption, and three kinds of internal fixation techniques were created and analyzed. Results: Under the vertical load, the displacements and shifts in the gap of the pelvis fixed with minimally invasive adjustable plate (MIAP) combined with one iliosacral (IS) screw were the smallest, and the average displacements of the pelvis fixed with an anterior plate were the largest one. The differences among them were significant. In finite element analysis and MIAP combined with one IS screw fixation showed relatively best fixation stability and lowest risks of implant failure than two IS screws fixation and anterior plate fixation. Conclusion: The stability of sacroiliac joint disruption fixed with MIAP combined with one IS screw is better than that fixed with two IS screws and anterior plate under vertical load. Keywords: Biomechanics, Internal fixation, Sacroiliac joint disruption, Finite element analyses
Background Sacroiliac joints (SIJs) play an important role in the pelvic ring, which is the main structure of force transmitting between the upper and lower limbs [1]. Sacroiliac joint disruption (SJD) is a severe clinical injury, caused by high-energy traumas. Although surgical treatment has become a gold-standard method for SJD in the recent years, how to select an appropriate fixation
* Correspondence: [email protected] 1 Department of Bone Disease, Third Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei, China Full list of author information is available at the end of the article
technique remains a challenging problem for clinical surgeon [2]. Currently, there are several internal fixation techniques for SJD, including percutaneous iliosacral (IS) screw, anterior plate, posterior transiliac plating, minimally invasive adjustable plate (MIAP), and so on [3–5]. These fixations have several advantages and disadvantages respectively, and none is proved to be the strongest fixation in the experiments and clinics. The percutaneous IS screws are widely used due to its advantage of a minimal incision at present. Osterhoff et al. treated the patients with unsta
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