DEVELOPMENT OF POLYAXIAL LOCKING PLATE SCREW SYSTEM OF SACROILIAC JOINT_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 FANWeijie , XIEXuesong , ZHOUShuping , ZHANGYonghu

Department of Orthopedics, the First Affiliated Hospital, University of South China, Hengyang Hunan, 421001, P. R. China;

Corresponding?author：

FANWeijie, Email: flygreatman@126.com

Keywords：

Sacroiliac joint dislocation; Polyaxial locking plate screw system of sacroiliac joint; Pelvic internal fixation

DOI：

10.7507/1002-1892.20140238

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Objective To develop an instrument for sacroiliac joint fixation with less injury and less complications. Methods Firstly, 18 adult pelvic specimens (8 males and 10 females) were used to measure the anatomical data related to the locking plates and locking screws on the sacrum and ilium, and the polyaxial locking plate screw system of the sacroiliac joint was designed according to the anatomic data. This system was made of medical titanium alloy. Then 4 adult male plevic specimens were harvested and the experiment was divided into 3 groups:group A (normal pelvic), group B (the dislocated sacroiliac joint fixed with sacroiliac screws), and group C (the dislocated sacroiliac joint fixed with polyaxial locking plate screw system). The vertical displacement of sacroiliac joint under the condition of 0-700 N vertical load and the horizontal displacement on angle under the condition of 0-12 N·m torsional load were compared among the 3 groups by using the biological material test system. Finally, the simulated application test was performed on 1 adult male cadaveric specimen to observe soft tissue injury and the position of the locking plate and screw by X-ray films. Results According to the anatomic data of the sacrum and ilium, the polyaxial locking plate screw system of the sacroiliac joint was designed. The biomechanical results showed that the vertical displacement of the sacroiliac joint under the condition of 0-700 N vertical load in group A was significantly bigger than that in group B and group C (P < 0.05), but there was no significant difference between group B and group C (P>0.05). The horizontal displacement on angle under the condition of 0-12 N·m torsional load in group A was significantly less than that in group B and group C (P < 0.05). The horizontal displacement on angle under the condition of 0-6 N·m torsional load in group B was bigger than that in group C, and the horizontal displacement on angle under the condition of 6-12 N·m torsional load in group B was less than that in group C, but there was no significant difference between group B and group C (P>0.05). The test of simulating application showed that the specimen suffered less soft tissue injury, and this instrument could be implanted precisely and safely. Conclusion The polyaxial locking plate screw system of the sacroiliac joint has the advantages of smaller volume and less injury; polyaxial fixation enables flexible adjustment screw direction. The simulated application test shows satisfactory fixing effect.

Citation： FANWeijie, XIEXuesong, ZHOUShuping, ZHANGYonghu. DEVELOPMENT OF POLYAXIAL LOCKING PLATE SCREW SYSTEM OF SACROILIAC JOINT. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(9): 1092-1095. doi: 10.7507/1002-1892.20140238 Copy

1.	Vigdorchik JM, Esquivel AO, Jin X, et al. Biomechanical stability of a supra-acetabular pedicle screw internal fixation device (INFIX) vs external fixation and plates for vertically unstable pelvic fractures. J Orthop Surg Res, 2012, 27:31.
2.	Vaidya R, Colen R, Vigdorchik J, et al. Treatment of unstable pelvic ring injuries with an internal anterior fixator and posterior fixation:initial clinical series. J Orthop Trauma, 2012, 26(1):1-8.
3.	宋世鋒, 彭磊, 肖海濤, 等.經皮骶髂螺釘與骶髂關節前方鋼板固定治療不穩定性骨盆骨折的對比研究.中華骨科雜志, 2011, 31(11):1191-1196.
4.	Salá?ek M, Pavelka T. Minimally invasive fixation of the pelvic ring with a transiliacal internal fixator. Acta Chir Orthop Traumatol Cech, 2012, 79(4):335-340.
5.	Marmor M, Lynch T, Matityahu A. Superior gluteal artery injury during iliosacral screw placement due to aberrant anatomy. Orthopedics, 2010, 33(2):117-120.
6.	Osterhoff G, Ossendorf C, Wanner GA, et al. Posterior screw fixation in rotationally unstable pelvic ring injuries. Injury, 2011, 42(10):992-996.
7.	Weil YA, Nousiainen MT, Helfet DL. Removal of an il iosacral screw entrapping the L₅ nerve root after failed posterior pelvic ring fixation:a case report. J Orthop Trauma, 2007, 21(6):414-417.
8.	Valente A, Nicodemo A, Bruno A, et al. Cerebrospinal fluid fistulas after iliosacral screw removal in post-traumatic pseudomeningocele. J Orthop Traumatol, 2012, 13(2):111-114.
9.	Mendel T, Noser H, Kuervers J, et al. The influence of sacral morphology on the existence of secure S1 and S2 transverse bone corridors for il iosacroiliac screw fixation. Injury, 2013, 44(12):1773-1779.
10.	尤傳飛, 袁峰, 葛保健, 等.經骶1-2側塊螺釘固定的解剖學研究.中國脊柱脊髓雜志, 2012, 22(7):641-644, 650.
11.	劉佳, 孫善全, 倪衛東, 等.骶髂關節前路鋼板螺釘固定手術安全區的應用解剖學研究.中國臨床解剖學雜志, 2012, 30(3):271-274.
12.	張奉琪, 潘進社, 張英澤, 等.骨盆骨折骶髂關節分離前路鋼板固定的應用解剖.中國臨床解剖學雜志, 2004, 22(2):120-121.
13.	陳偉, 王滿宜, 張奇, 等.三種內固定物固定骨盆后環損傷穩定性的生物力學比較.中華骨科雜志, 2011, 31(11):1232-1238.
14.	Lehmann W, Gro?terlinden L, Rueger JM. Posterior approaches to the pelvic ring. Unfallchirurg, 2013, 116(3):205-212.
15.	Pavelka T, Salá?ek M, Weisová D. Complications associated with surgical treatment of pelvic ring fractures. Acta Chir Orthop Traumatol Cech, 2013, 80(3):208-215.
16.	Chen HW, Liu GD, Fei J, et al. Treatment of unstable posterior pelvic ring fracture with percutaneous reconstruction plate and percutaneous sacroiliac screws:a comparative study. J Orthop Sci, 2012, 17(5):580-587.
17.	田素魁, 房曉彬, 王振強, 等.使用TOS裝置固定術治療垂直不穩定型骨盆骨折.實用骨科雜志, 2012, 18(7):598-600.

1. Vigdorchik JM, Esquivel AO, Jin X, et al. Biomechanical stability of a supra-acetabular pedicle screw internal fixation device (INFIX) vs external fixation and plates for vertically unstable pelvic fractures. J Orthop Surg Res, 2012, 27:31.
2. Vaidya R, Colen R, Vigdorchik J, et al. Treatment of unstable pelvic ring injuries with an internal anterior fixator and posterior fixation:initial clinical series. J Orthop Trauma, 2012, 26(1):1-8.
3. 宋世鋒, 彭磊, 肖海濤, 等.經皮骶髂螺釘與骶髂關節前方鋼板固定治療不穩定性骨盆骨折的對比研究.中華骨科雜志, 2011, 31(11):1191-1196.
4. Salá?ek M, Pavelka T. Minimally invasive fixation of the pelvic ring with a transiliacal internal fixator. Acta Chir Orthop Traumatol Cech, 2012, 79(4):335-340.
5. Marmor M, Lynch T, Matityahu A. Superior gluteal artery injury during iliosacral screw placement due to aberrant anatomy. Orthopedics, 2010, 33(2):117-120.
6. Osterhoff G, Ossendorf C, Wanner GA, et al. Posterior screw fixation in rotationally unstable pelvic ring injuries. Injury, 2011, 42(10):992-996.
7. Weil YA, Nousiainen MT, Helfet DL. Removal of an il iosacral screw entrapping the L₅ nerve root after failed posterior pelvic ring fixation:a case report. J Orthop Trauma, 2007, 21(6):414-417.
8. Valente A, Nicodemo A, Bruno A, et al. Cerebrospinal fluid fistulas after iliosacral screw removal in post-traumatic pseudomeningocele. J Orthop Traumatol, 2012, 13(2):111-114.
9. Mendel T, Noser H, Kuervers J, et al. The influence of sacral morphology on the existence of secure S1 and S2 transverse bone corridors for il iosacroiliac screw fixation. Injury, 2013, 44(12):1773-1779.
10. 尤傳飛, 袁峰, 葛保健, 等.經骶1-2側塊螺釘固定的解剖學研究.中國脊柱脊髓雜志, 2012, 22(7):641-644, 650.
11. 劉佳, 孫善全, 倪衛東, 等.骶髂關節前路鋼板螺釘固定手術安全區的應用解剖學研究.中國臨床解剖學雜志, 2012, 30(3):271-274.
12. 張奉琪, 潘進社, 張英澤, 等.骨盆骨折骶髂關節分離前路鋼板固定的應用解剖.中國臨床解剖學雜志, 2004, 22(2):120-121.
13. 陳偉, 王滿宜, 張奇, 等.三種內固定物固定骨盆后環損傷穩定性的生物力學比較.中華骨科雜志, 2011, 31(11):1232-1238.
14. Lehmann W, Gro?terlinden L, Rueger JM. Posterior approaches to the pelvic ring. Unfallchirurg, 2013, 116(3):205-212.
15. Pavelka T, Salá?ek M, Weisová D. Complications associated with surgical treatment of pelvic ring fractures. Acta Chir Orthop Traumatol Cech, 2013, 80(3):208-215.
16. Chen HW, Liu GD, Fei J, et al. Treatment of unstable posterior pelvic ring fracture with percutaneous reconstruction plate and percutaneous sacroiliac screws:a comparative study. J Orthop Sci, 2012, 17(5):580-587.
17. 田素魁, 房曉彬, 王振強, 等.使用TOS裝置固定術治療垂直不穩定型骨盆骨折.實用骨科雜志, 2012, 18(7):598-600.

Chinese Journal of Reparative and Reconstructive Surgery

DEVELOPMENT OF POLYAXIAL LOCKING PLATE SCREW SYSTEM OF SACROILIAC JOINT

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