Screw- versus plate-fixation strength of acetabular anterior column fractures

Gras, Florian; Marintschev, Ivan; Schwarz, Christoph E.; Hofmann, Gunther O.; Pohlemann, Tim; Culemann, Ulf

doi:10.1097/ta.0b013e3182463b45

Cited by 55 publications

(62 citation statements)

References 26 publications

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“…However, the results of the current study suggest that a more rigid fixation is possible by Kocher-Langenbeck approach for transverse fractures. Gras et al have recently reported screw fixation of the anterior column to be equivalent to anterior column plating in fixation strength [16]. This was in concurrence with our study that screw fixation of the anterior column was comparable with anterior column plating.…”

Section: Discussionsupporting

confidence: 94%

Finite element analysis of the stability of transverse acetabular fractures in standing and sitting positions by different fixation options

Yıldırım

Alemdaroğlu

Yüksel

et al. 2015

Injury

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Section: Discussionsupporting

confidence: 94%

Finite element analysis of the stability of transverse acetabular fractures in standing and sitting positions by different fixation options

Yıldırım

Alemdaroğlu

Yüksel

et al. 2015

Injury

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“…The recently described infraacetabular screw placement seems to be a promising alternative to increase fracture fixation strength up to 50% by closing the periacetabular fixation frame as shown in two biomechanical studies [11,24]. In our clinical experience, the infraacetabular corridor of some patients is too narrow or has a bowing shape; this may exclude secure intraosseous screw placement.…”

Section: Introductionmentioning

confidence: 85%

Sex-specific Differences of the Infraacetabular Corridor: A Biomorphometric CT-based Analysis on a Database of 523 Pelves

Gras

Gottschling

Schröder

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background An infraacetabular screw path facilitates the closure of a periacetabular fixation frame to increase the plate fixation strength in acetabular fractures up to 50%. Knowledge of the variance in corridor sizes and axes has substantial surgical relevance for safe screw placement. Questions/purposes (1) What proportion of healthy pelvis specimens have an infraacetabular corridor that is 5 mm or larger in diameter? (2) Does a universal corridor axis and specific screw entry point exist? (3) Are there sex-specific differences in the infraacetabular corridor size or axis and are these correlated with anthropometric parameters like age, body weight and height, or the acetabular diameter? Methods A template pelvis with a mean shape from 523 segmented pelvis specimens was generated using a CTbased advanced image analyzing system. Each individual pelvis was registered to the template using a free-form registration algorithm. Feasible surface regions for the entry and exit points of the infraacetabular corridor were marked on the template and automatically mapped to the individual samples to perform a measurement of the maximum sizes and axes of the infraacetabular corridor on each specimen. A minimum corridor diameter of at least 5 mm was defined as a cutoff for placing a 3.5-mm cortical screw in clinical settings. Results In 484 of 523 pelves (93%), an infraacetabular corridor with a diameter of at least 5 mm was found. Using the mean axis angulations (54.8°[95% confidence interval {CI}, 0.6] from anterocranial to posterocaudal in relation to the anterior pelvic plane and 1.5°[95% CI, 0.4] from anteromedial to posterolateral in relation to the sagittal midline plane), a sufficient osseous corridor was present in 64% of pelves. Allowing adjustment of the three-dimensional axis by another 5°included an additional 25% of pelves. All corridor parameters were different between females and males (corridor diameter, 6.9 [95% CI, 0

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“…methods underlining the necessity of stable osteosynthesis to prevent re-displacement of the QLP [6,24]. However, the lack of homogeneity in biomechanical test set-ups aggravates comparison under full weight-bearing conditions [6,7,10,17,22,24,33,36]. In particular no comparative biomechanical data has been made available regarding cages designed for primary THA which address displaced acetabular fractures in the elderly.…”

Section: Introductionmentioning

confidence: 99%

Comparison of two reinforcement rings for primary total hip arthroplasty addressing displaced acetabular fractures: a biomechanical analysis

Becker

Winkler

Rüden

et al. 2020

Arch Orthop Trauma Surg

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Introduction Aim of this study was to biomechanically compare two different acetabular cup fixation constructs in terms of fracture fixation for displaced acetabular fractures involving the anterior column with hemitransverse fracture under partial and full weight-bearing conditions. Methods Two different reinforcement rings designed as cages for primary THA were biomechanically tested in terms of managing a complex acetabular fracture. Single-leg stance cyclic loading was performed to assess fracture gap movement and fragment rotation. Twelve hemi pelvis Sawbones were divided into two groups: primary THA with acetabulum roof reinforcement plate (ARRP) (n = 6) and primary THA with Burch-Schneider reinforcement cage (BSRC) (n = 6). Results During loading under partial weight-bearing (250 N) fracture gap movement tended to be larger in the BSRC group as compared to the ARRP group. Under full weight-bearing conditions, the ARRP showed 60% significantly less motion (p = 0.035) of the os ilium to os ischii gap compared to BSRC. Fracture gap movements between the os ilium and spina iliaca fragments were significantly reduced by 76% (p = 0.048) for ARRP in contrast to BSRC. The ARRP group also demonstrated significantly less movement in the fracture gaps os ischii to quadrilateral plate (62% reduction, p = 0.009) and quadrilateral plate to spina iliaca (87% reduction, p < 0.001). Significantly less rotational movement of the quadrilateral plate to the os ilium was exhibited by the ARRP group (p = 0.015). Conclusions The presented acetabulum roof-reinforcement plate (ARRP) provides stable conditions at the acetabular component with adequate stabilization of a displaced acetabular fracture.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Screw- versus plate-fixation strength of acetabular anterior column fractures

Abstract: Therapeutic study, level IV.

Cited by 55 publications

References 26 publications

Finite element analysis of the stability of transverse acetabular fractures in standing and sitting positions by different fixation options

Finite element analysis of the stability of transverse acetabular fractures in standing and sitting positions by different fixation options

Sex-specific Differences of the Infraacetabular Corridor: A Biomorphometric CT-based Analysis on a Database of 523 Pelves

Comparison of two reinforcement rings for primary total hip arthroplasty addressing displaced acetabular fractures: a biomechanical analysis

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