Comparison of different fixation methods of bicolumnar acetabular fractures

Bodzay, Tamás; Sztrinkai, Gergely; Kocsis, András; Kozma, Báliinstnt; Gál, Tamás; Váradi, Károly

doi:10.5606/ehc.2018.59268

Cited by 6 publications

(5 citation statements)

References 7 publications

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“…The current biomechanical finite element study of acetabular internal fixation has two limitations: (1) inaccurate description of fracture morphology, and (2) not already defined width and thickness of the plate as well as diameter & length of screws, resulting in low comparability of experiment. 18 , 23 , 24 Biomechanical studies have shown that the stress on the weight-bearing area of acetabular dome is the most concentrated, which requires anatomical reduction and effective fixation. 21 , 22 If the implant cannot effectively fix the displaced articular fragments, postoperative movements will result in reduction loss, implant loosening or rupture.…”

Section: Discussionmentioning

confidence: 99%

A novel anatomical self-locking plate fixation for both-column acetabular fractures

Li¹,

Wang²,

Xiao³

2022

Chinese Journal of Traumatology

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Section: Discussionmentioning

confidence: 99%

A novel anatomical self-locking plate fixation for both-column acetabular fractures

Li¹,

Wang²,

Xiao³

2022

Chinese Journal of Traumatology

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“…2. The width and thickness of the plate, the diameter and length of screw are not defined, resulting in low repeatability of experiment [18,[23][24].…”

Section: Discussionmentioning

confidence: 99%

A Novel Anatomical Self-locking Plate Fixation for Both-column Acetabular Fractures: - Finite Element Analysis

Li¹,

Xu²,

Zhang³

et al. 2021

Preprint

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Background: Both-column acetabular fractures often require multiple plates for fixation, and the risk of internal implant failure is high. The author designed a posterior anatomic self-locking plate (PASP) to avoid the shortcomings. The stability of PASP was compared with two popular reconstruction plate fixation methods, and the influence of sitting, turning right and left on implants were explored. Methods: PASP, double reconstruction plate (DRP), and cross reconstruction plate (CRP) were assembled on the finite element model of both-column fractures of the left acetabulum. A load of 600N and a torque of 8N·m were loaded on the S1 vertebral body to detect stress and displacement changes when sitting, turning right and left. Results: The peak stress and displacement of three types of fixation methods on the left both-column fractures under three types of movements were CRP > DRP > PASP. PASP has the minimal value when turning left. The maximum peak of stress and displacement of PASP are 313.5 MPa and 1.15 mm respectively when turning right. Conclusion: PASP can provide higher stability than two reconstruction plates for both-column acetabular fractures. The rational movement after posterior DRP and PASP fixation for acetabular fracture is to turn to the ipsilateral side, which can avoid implant failure.

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“…This might be a considerable factor influencing fracture healing, although we proved in our previous experiments that after fixation of the anterior column (our system is suitable also for this thanks to the grooves), the iliac bone did not require any additional fixation. [6] As a supplement, we provided CT scans taken under load three months after surgery. According to the results of simulation, the screw exposed to the strongest stress broke.…”

Section: Discussionmentioning

confidence: 99%

“…However, according to our former calculations and measurements, the system may be properly simplified: the cancellous bone mass with lower stress resistance cannot be considered negligible, compared to the predominant cortical bone substance; however, it may be averaged, and the ligament system not providing any physical stress transmission due to the injury can be neglected. [6] Accordingly, solid-state physics constants applied in our measurements are represented (Table I).…”

Section: Methodsmentioning

confidence: 99%

Hybrid solution combining osteosynthesis and endoprosthesis for double column acetabular fractures in the elderly provide more stability with finite element model

Kocsis

Váradi²,

Szalai³

et al. 2019

Eklem Hastalik Cerrahisi

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ÖZAmaç: Bu çalışmada yaşlılarda çift kolon kırıklarında osteosenteze (plak ve vida tespiti) kıyasla kalça artroplastisi ile desteklenen aynı yöntemin (hibrid çözüm) mekanik stabilitesi karşılaştırıldı. Hastalar ve yöntemler: Çift kolon kırıkları için geliştirilen ileri sonlu eleman pelvis modelinde mekanik araştırmalar yapıldı. İncelenen simüle edilen implant kombinasyonları şunlardı: poliaksiyel vidalı ve U plaklı, halkalı, modüler asetabüler sepet; medial horizontal (linea terminalis) ve kuadrilateral kemik yüzeylerine yerleştirilen poliaksiyel vidalı plaklar; U plaklı, modüler asetabüler kap ve çeşitli ebatlarda sonlu eleman modeline (FEM) göre optimize edilen poliaksiyel vidalar. Bu modellerde yük, gerilim ve implant deformasyonuna bağlı farklı hareket paternlerinden doğan pik yük pozisyonlarındaki muhtemel kaymalar ölçüldü. Bulgular: Hibrid sistemler, piyasada bulunan implantlarda minimum deformasyona neden oldu. Tek başına konvansiyonel osteosenteze kıyasla, asetabüler kırık bölgelerinde daha az muhtemel kayma ve daha yüksek stabilite gözlendi. Mevcut ve uygun implant ebatlarına göre optimizasyon yapıldığında, stabilitede anlamlı düzeyde ilave bir artış izlendi. Sonuç: Yaşlılarda çift kolon kırıklarının tedavisinde biyomekanik modellerde osteosentez ve protez implantasyonunu içeren hibrid yöntem daha fazla stabilite sağlamaktadır.Anahtar sözcükler: Asetabüler kırık, asetabulum, sonlu eleman modeli, pelvik travma, plak osteostentezi, total kalça replasmanı. ABSTRACTObjectives: This study aims to compare mechanical stability of osteosynthesis (plate and screw fixation) alone versus the same method supplemented with hip arthroplasty (hybrid solution) for double column fractures in elderly. Patients and methods: Mechanical investigations were performed on an advanced finite element pelvis model developed for double column fractures. The following simulated implant combinations were analyzed: modular acetabular basket with a ring with polyaxial screws and U-plate; plates with polyaxial screws placed on the medialhorizontal (linea terminalis) and quadrilateral bone surfaces; modular acetabular cup with U-plates; and polyaxial screws in sizes optimized based on a finite element model (FEM). Using the models, the possible shifts in peak load positions arising in different movement patterns caused by load and tension and implant deformation were measured. Results: Hybrid systems resulted in minimal deformation of the implants already available on the market. We observed less possible shifts and greater stability in the acetabular fracture zones, compared to conventional osteosynthesis alone. Optimization with available and compatible implant sizes led to a further significant increase in stability. Conclusion: Hybrid method combining osteosynthesis and prosthesis implantation provide more stability in biomechanical models in the treatment of double column fractures in elderly.

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Comparison of different fixation methods of bicolumnar acetabular fractures

Cited by 6 publications

References 7 publications

A novel anatomical self-locking plate fixation for both-column acetabular fractures

A novel anatomical self-locking plate fixation for both-column acetabular fractures

A Novel Anatomical Self-locking Plate Fixation for Both-column Acetabular Fractures: - Finite Element Analysis

Hybrid solution combining osteosynthesis and endoprosthesis for double column acetabular fractures in the elderly provide more stability with finite element model

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