In Silico Evaluation of the Primary Stability of Acetabular Revision Cups: Standard Versus Locking Screws.

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Abstract

[Indexed for MEDLINE] 7. J Orthop Surg Res. 2021 Jul 3;16(1):428. doi: 10.1186/s13018-021-02581-5. Biomechanical study of transsacral-transiliac screw fixation versus lumbopelvic fixation and bilateral triangular fixation for "H"- and "U"-type sacrum fractures with traumatic spondylopelvic dissociation: a finite element analysis study. Peng Y(#)(1), Zhang G(#)(1), Zhang S(1), Ji X(1), Li J(2), Du C(3), Zhao W(4), Zhang L(5). Author information: (1)Department of Orthopaedic Surgery, General Hospital of Chinese People's Liberation Army, 28 Fu-Xing Road, 100853, Beijing, People's Republic of China. (2)Tianjin Key Laboratory for Advanced Mechatronic System Design and Intelligent Control, School of Mechanical Engineering, Tianjin University of Technology, Tianjin, People's Republic of China. (3)Tianjin Key Laboratory for Advanced Mechatronic System Design and Intelligent Control, School of Mechanical Engineering, Tianjin University of Technology, Tianjin, People's Republic of China. ddccffb31@hotmail.com. (4)Department of Orthopedics, Beijing Aerospace General Hospital, Beijing, People's Republic of China. 13601136518@126.com. (5)Department of Orthopaedic Surgery, General Hospital of Chinese People's Liberation Army, 28 Fu-Xing Road, 100853, Beijing, People's Republic of China. zhanglihai74@hotmail.com. (#)Contributed equally OBJECTIVE: To compare the biomechanical stability of transsacral-transiliac screw fixation and lumbopelvic fixation for "H"- and "U"-type sacrum fractures with traumatic spondylopelvic dissociation. METHODS: Finite element models of "H"- and "U"-type sacrum fractures with traumatic spondylopelvic dissociation were created in this study. The models mimicked the standing position of a human. Fixation with transsacral-transiliac screw fixation, lumbopelvic fixation, and bilateral triangular fixation were simulated. Biomechanical tests of instability were performed, and the fracture gap displacement, anteflexion, rotation, and stress distribution after fixation were assessed. RESULTS: For H-type fractures, the three kinds of fixation ranked by stability were bilateral triangular fixation > lumbopelvic fixation > transsacral-transiliac screw fixation in the vertical and anteflexion directions, bilateral triangular fixation > transsacral-transiliac S1 and S2 screw fixation > lumbopelvic fixation in rotation. The largest displacements in the vertical, anteflexion, and rotational directions were 0.57234 mm, 0.37923 mm, and 0.13076 mm, respectively. For U-type fractures, these kinds of fixation ranked by stability were bilateral triangular fixation > lumbopelvic fixation > transsacral-transiliac S1 and S2 screw fixation > transsacral-transiliac S1 screw fixation in the vertical, anteflexion, and rotational directions. The largest displacements in the vertical, anteflexion, and rotational directions were 0.38296 mm, 0.33976 mm, and 0.05064 mm, respectively. CONCLUSION: All these kinds of fixation met the mechanical criteria for clinical applications. The biomechanical analysis showed better bilateral balance with transsacral-transiliac screw fixation. The maximal displacement for these types of fixation was less than 1 mm. Percutaneous transsacral-transiliac screw fixation can be considered the best option among these kinds of fracture fixation. DOI: 10.1186/s13018-021-02581-5 PMCID: PMC8254325