Stabilization of a Type B1.1 Injury in a Morbidly Obese Patient Using an Internal Fixator in a Minimally Invasive Technique

Fritz, Tobias; Braun, Benedikt J.; Veith, Nils T.; Hopp, Sascha; Mettelsiefen, Laura; Strobel, Friedemann; Pohlemann, Tim; Pizanis, A.

doi:10.2106/jbjs.cc.18.00075

Cited by 5 publications

(25 citation statements)

References 22 publications

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“…Further steps were per-formed as in the other groups. As used in spine surgery, this technique can clinically be performed in a minimally invasive approach [4].…”

Section: Stabilization Using the Internal Fixator (If Group)mentioning

confidence: 99%

“…Sensor films were placed in the symphysis and the symphyseal gap was reduced with a tong (Synthes, Umkirch, Germany) that was applied at prepared spots on both sides of the pubic symphysis, until a defined compression force of 50 N was obtained [4,15]. Corresponding forces inside the pubic symphysis and the contact area were measured at the end of each step by I-scan ® sensor films (TekScan, USA) [4].…”

Section: Stabilization Using the Internal Fixator (If Group)mentioning

confidence: 99%

“…After each reduction and after every step, compressive forces and the contact area were measured with I-scan ® sensor films 5033 (TekScan, USA). In addition, the contact areas of the cranial, central, and caudal thirds of the symphysis (contact distribution in %) were assessed with I-scan software 6.02 (TekScan, USA) to represent an indicator for reduction quality [4]. The spatial instability and movement were acquired by an optical tracking system (Prime 13 ® , Optitrack, USA).…”

Section: Data Acquisition Processing and Statistical Analysismentioning

confidence: 99%

“…Differences between groups were analyzed with Kruskal-Wallis analysis of variance (ANOVA) on ranks with post hoc Student-Newman-Keuls test. A p value < 0.05 was defined to indicate significant differences [4].…”

Section: Data Acquisition Processing and Statistical Analysismentioning

confidence: 99%

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A novel minimally invasive and press‐fit method for symphysiodesis — a biomechanical analysis

Fritz,

Orth,

Hopp

et al. 2023

J. exp. orthop.

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Purpose Does the cylindrical shaped bone block allow a stable construct for the arthrodesis of the pubic symphysis compared to a rectangular shaped bone block. The cylindrical shaped bone block stabilized by a 3.5 symphyseal plate is inferior to the stabilization with an internal fixator. Methods This study analyzed the arthrodesis of the pubic symphysis on 24 synthetic pelvises, using a rectangular shaped bone block (control group) or a cylindrical shaped bone block, stabilized with a symphysis locking plate (n = 8) as the standard clinical procedure. Additionally we analyzed the stability using an internal fixator. Results This study showed that utilizing a cylindrical shaped synthetic bone graft results in a significant higher contact area and compression force compared to the classical rectangular shaped graft. Furthermore, the stabilization with an internal fixator had the tendency for increases of compression force and contact area, yet without a statistical significance, when compared to the plate fixation. Conclusion The novel method of cylindrical symphysis resection and cylindrical bone block implantation allowed an increased biomechanical stability compared to using a classical rectangular bone graft, also resulting in higher contact area. Moreover, this technique would also allow a minimally invasive approach for this purpose, which in turn could preserve perisymphyseal ligaments, thereby improving healing in a clinical context.

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“…Further steps were per-formed as in the other groups. As used in spine surgery, this technique can clinically be performed in a minimally invasive approach [4].…”

Section: Stabilization Using the Internal Fixator (If Group)mentioning

confidence: 99%

Section: Stabilization Using the Internal Fixator (If Group)mentioning

confidence: 99%

Section: Data Acquisition Processing and Statistical Analysismentioning

confidence: 99%

Section: Data Acquisition Processing and Statistical Analysismentioning

confidence: 99%

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A novel minimally invasive and press‐fit method for symphysiodesis — a biomechanical analysis

Fritz,

Orth,

Hopp

et al. 2023

J. exp. orthop.

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“…The ongoing search for alternative techniques underscores the controversy surrounding SP fixation. Suture tapes 13,14 , percutaneous screws 15 , and the use of spine implants for internal fixation 16,17 are just some of the recently introduced alternative fixation techniques. The current literature confirms that there is a need for an alternative fixation device without the risk of screw loosening or plate breakage.…”

Section: Plain Language Summarymentioning

confidence: 99%

Development and preclinical evaluation of a cable-clamp fixation device for a disrupted pubic symphysis

et al. 2022

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Background Traumatic separation of the pubic symphysis can destabilize the pelvis and require surgical fixation to reduce symphyseal gapping. The traditional approach involves open reduction and the implantation of a steel symphyseal plate (SP) on the pubic bone to hold the reposition. Despite its widespread use, SP-fixation is often associated with implant failure caused by screw loosening or breakage. Methods To address the need for a more reliable surgical intervention, we developed and tested two titanium cable-clamp implants. The cable served as tensioning device while the clamp secured the cable to the bone. The first implant design included a steel cable anterior to the pubic symphysis to simplify its placement outside the pelvis, and the second design included a cable encircling the pubic symphysis to stabilize the anterior pelvic ring. Using highly reproducible synthetic bone models and a limited number of cadaver specimens, we performed a comprehensive biomechanical study of implant stability and evaluated surgical feasibility. Results We were able to demonstrate that the cable-clamp implants provide stability equivalent to that of a traditional SP-fixation but without the same risks of implant failure. We also provide detailed ex vivo evaluations of the safety and feasibility of a trans-obturator surgical approach required for those kind of fixation. Conclusion We propose that the developed cable-clamp fixation devices may be of clinical value in treating pubic symphysis separation.

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A novel internal fixation method for open book injuries of the pubic symphysis— A biomechanical analysis

Fritz

Mettelsiefen

Strobel

et al. 2020

Clinical Biomechanics

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Stabilization of a Type B1.1 Injury in a Morbidly Obese Patient Using an Internal Fixator in a Minimally Invasive Technique

Cited by 5 publications

References 22 publications

A novel minimally invasive and press‐fit method for symphysiodesis — a biomechanical analysis

A novel minimally invasive and press‐fit method for symphysiodesis — a biomechanical analysis

Development and preclinical evaluation of a cable-clamp fixation device for a disrupted pubic symphysis

A novel internal fixation method for open book injuries of the pubic symphysis— A biomechanical analysis

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