BIOMECHANICAL RESEARCH OF DIFFERENT INTERNAL FIXATIONS USING LOCKING RECONSTRUCTION PLATE FOR ACETABULAR TRANSVERSE FRACTURE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIUHongyang ^1,2 ,  LILigeng ¹ , WUXiaobo ¹ , XUHongjia ³ , ZHANGRuijie ¹

1. Department of Orthopaedics and Traumatology, the 2nd Hospital of Tangshan(North China University of Science and Technology Affiliated Orthopedic Hospital), Tangshan Hebei, 063000, P. R. China;
2. School of Graduate, North China University of Science and Technology;
3. School of Public Health, North China University of Science and Technology;

Corresponding?author：

LILigeng, Email: liligengyz@163.com

Keywords：

Acetabular transverse fracture; Internal fixation; Biomechanics

DOI：

10.7507/1002-1892.20150235

Video：

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Objective To compare the biomechanical stability of acetabular transverse fracture fixed with single column locking reconstruction plate, locking reconstruction plate combined with lag screw, and double columns lag screws. Methods Acetabular transverse fractures were established in 20 adult fresh semi-pelvis specimens, and divided into 5 groups randomly (n=4). The anterior columns were fixed with locking reconstruction plates in group A; the posterior columns were fixed with locking reconstruction plates in group B; the anterior columns were fixed with locking reconstruction plates and the posterior columns with lag screws in group C; the anterior columns were fixed with lag screws and the posterior columns with locking reconstruction plates in group D; the double columns were fixed with lag screws in group E. When loading three times weight, the longitudinal displacement of fracture fragment was measured, and the shear rigidity was calculated to compare the stability among groups. Results The longitudinal displacement of groups A and B were significantly greater than that of groups C, D, and E (P<0.05), and the shear rigidity of groups A and B were significantly lower than that of groups C, D, and E (P<0.05). The longitudinal displacement of group B was significantly greater than that of group A (P<0.05), but no significant difference was found in the shear rigidity between groups A and B (P>0.05). There was no significant difference in the longitudinal displacement and shear rigidity among groups C, D, and E (P>0.05). Conclusion Locking reconstruction plate combined with lag screw and double columns lag screws have similar stability, they have stronger stability than the single column locking reconstruction plate. The stability of anterior column locking reconstruction plate is better than that of the posterior column locking reconstruction plate.

Citation： LIUHongyang, LILigeng, WUXiaobo, XUHongjia, ZHANGRuijie. BIOMECHANICAL RESEARCH OF DIFFERENT INTERNAL FIXATIONS USING LOCKING RECONSTRUCTION PLATE FOR ACETABULAR TRANSVERSE FRACTURE. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(9): 1084-1087. doi: 10.7507/1002-1892.20150235 Copy

1.	Geijer M,EI-Khoury GY.Imaging of acetabulum in the era of multidector computed tomographt. Emerg Radiol, 2007, 15(5):271-287.
2.	Bia?as A, Krauze P, Walenczak K. Distal humeral AO type C fracture-analysis of LCP fixation. Ortop Traumatol Rehabil, 2013, 15(6):297-304.
3.	Sen RK, Tripathy SK, Aggarwal S, et al. A safe technique of anterior column lag screw fixation in acetabular fractures. Int Orthop, 2012, 36(11):2333-2340.
4.	Marintschev I, Gras F, Schwarz CE, et al. Biomechanical comparison of different acetabular plate systems and constructs-the role of an infra-acetabular screw placement and use of locking plates. Injury, 2012, 43(4):470-474.
5.	Lee CW, Liao CH, Lin CL, et al. Increased risk of osteoporosis in patients with depression:a population-based retrospective cohort study. Mayo Clin Proc, 2015, 90(1):63-70.
6.	Olson SA, Kadrmas MW, Hermandez JD, et al. Augmentation of posterior wall acetabular fracture fixation using calclum-phosphate cement:a biomechanical analysis. J Orthop Trauma, 2007, 21(9): 608-616.
7.	Shazar N, Brumback RJ, Novak VP, et al. Biomechanical evaluation of transverse acetabular fracture fixation. Clin Orthop Relat Res, 1998, (352):215-222.
8.	Ji X, Bi C, Wang F, et al. Digital anatomical measurements of safe screw placement at superior border of the arcuate line for acetabular fractures. BMC Musculoskelet Disord, 2015, 16:55.
9.	Wu X, Chen W, Zhang Q, et al. The study of plate-screw fixation in the posterior wall of acetabulum using computed tomography images. J Trauma, 2010, 69(2):423-431.
10.	王慶賢, 張英澤, 潘進社, 等. 髖臼后柱拉力螺釘內固定的應用解剖學. 中國臨床解剖學雜志, 2004, 22(6):596-598.
11.	Ebraheim NA, Xu R, Biyani A, et al. Anatomic basis of lag screw placement in the anterior column of the acetabulum. Clin Orthop Relat Res, 1997, (339):200-205.
12.	Sen RK, Tripathy SK, Aggarwal S, et al. A safe technique of anterior column lag screw fixation in acetabular fractures. Int Orthop, 2012,36 (11):2333-2340.
13.	Mehin R, Jones B, Zhu Q, et al. A biomechanical study of conventional acetabular internal fracture fixation versus locking plate fixation. Can J Surg, 2009, 52(3):221-228.
14.	Chang JK, Gill SS, Zura RD, et al. Comparative strength of three methods of fixation of transverse acetabular fractures. Clin Orthop Relat Res, 2001, (392):433-441.
15.	吳嘯波, 張奇, 郭明珂, 等. 髖臼后柱骨折不同方式鋼板內固定的穩定性研究. 第三軍醫大學學報, 2010, 32(7):665-668.
16.	張繼宗. 法醫人類學基礎. 北京:科學出版社, 2007:380-388.
17.	李思漢. 我國北方地區成人各類體型不同身高的體重正常值的探討. 營養學報, 1986, 8(2):98-109.
18.	Kaku N, Tsumura H, Taira H, et al. Biomechanical study of load transfer of the pubic ramus due to pelvic inclination after hip joint surgery using a three-dimensional finite element model. J Orthop Sci, 2004, 9(3):264-269.
19.	Dalstra M, Huiskes R. Load transfer across the pelvic bone. J Biomech, 1995, 28(6):715-724.
20.	榮國威, 王承武. 骨折. 北京:人民衛生出版社, 2004:844-847.
21.	毛賓堯. 人工全髖關節翻修外科的生物力學. 中國矯形外科雜志, 2003, 11(10):672-674.
22.	Harris AM, Althausen P, Keiiam JF, et al. Simultaneous anterior and posterior approaches for complex acetabular fractures. J Orthop Trauma, 2008, 22(7):494-497.
23.	St?ckle U, Hoffmann R, Nittinger M, et al. Screw fixation of acetabular fractures. Int Orthop, 2000, 24(3):143-147.
24.	Dienstknecht T, Müller M, Sellei R, et al. Screw placement in percutaneous acetabular surgery:gender differences of anatomical landmarks in a cadaveric study. Int Orthop, 2013, 37(4):673-679.
25.	穆衛東. 計算機導航引導下骨盆和髖臼骨折微創經皮空心拉力螺釘技術的基礎及應用研究. 濟南:山東大學, 2009.
26.	張秋林, 唐昊, 王秋根, 等. 鎖定加壓重建鋼板在髖臼骨折中的應用. 中華關節外科雜志:電子版, 2008, 2(2):129-133.
27.	Harnroongroj T. The role of the anterior column of the acetabulum on pelvic stability:a biomechanical study. Injury, 1998, 29(4):293-296.
28.	王慶賢, 張英澤, 潘進社, 等. 髖臼橫斷骨折不同內固定方式的生物力學研究及臨床意義. 中華創傷骨科雜志, 2005, 7(3):259-262.

1. Geijer M,EI-Khoury GY.Imaging of acetabulum in the era of multidector computed tomographt. Emerg Radiol, 2007, 15(5):271-287.
2. Bia?as A, Krauze P, Walenczak K. Distal humeral AO type C fracture-analysis of LCP fixation. Ortop Traumatol Rehabil, 2013, 15(6):297-304.
3. Sen RK, Tripathy SK, Aggarwal S, et al. A safe technique of anterior column lag screw fixation in acetabular fractures. Int Orthop, 2012, 36(11):2333-2340.
4. Marintschev I, Gras F, Schwarz CE, et al. Biomechanical comparison of different acetabular plate systems and constructs-the role of an infra-acetabular screw placement and use of locking plates. Injury, 2012, 43(4):470-474.
5. Lee CW, Liao CH, Lin CL, et al. Increased risk of osteoporosis in patients with depression:a population-based retrospective cohort study. Mayo Clin Proc, 2015, 90(1):63-70.
6. Olson SA, Kadrmas MW, Hermandez JD, et al. Augmentation of posterior wall acetabular fracture fixation using calclum-phosphate cement:a biomechanical analysis. J Orthop Trauma, 2007, 21(9): 608-616.
7. Shazar N, Brumback RJ, Novak VP, et al. Biomechanical evaluation of transverse acetabular fracture fixation. Clin Orthop Relat Res, 1998, (352):215-222.
8. Ji X, Bi C, Wang F, et al. Digital anatomical measurements of safe screw placement at superior border of the arcuate line for acetabular fractures. BMC Musculoskelet Disord, 2015, 16:55.
9. Wu X, Chen W, Zhang Q, et al. The study of plate-screw fixation in the posterior wall of acetabulum using computed tomography images. J Trauma, 2010, 69(2):423-431.
10. 王慶賢, 張英澤, 潘進社, 等. 髖臼后柱拉力螺釘內固定的應用解剖學. 中國臨床解剖學雜志, 2004, 22(6):596-598.
11. Ebraheim NA, Xu R, Biyani A, et al. Anatomic basis of lag screw placement in the anterior column of the acetabulum. Clin Orthop Relat Res, 1997, (339):200-205.
12. Sen RK, Tripathy SK, Aggarwal S, et al. A safe technique of anterior column lag screw fixation in acetabular fractures. Int Orthop, 2012,36 (11):2333-2340.
13. Mehin R, Jones B, Zhu Q, et al. A biomechanical study of conventional acetabular internal fracture fixation versus locking plate fixation. Can J Surg, 2009, 52(3):221-228.
14. Chang JK, Gill SS, Zura RD, et al. Comparative strength of three methods of fixation of transverse acetabular fractures. Clin Orthop Relat Res, 2001, (392):433-441.
15. 吳嘯波, 張奇, 郭明珂, 等. 髖臼后柱骨折不同方式鋼板內固定的穩定性研究. 第三軍醫大學學報, 2010, 32(7):665-668.
16. 張繼宗. 法醫人類學基礎. 北京:科學出版社, 2007:380-388.
17. 李思漢. 我國北方地區成人各類體型不同身高的體重正常值的探討. 營養學報, 1986, 8(2):98-109.
18. Kaku N, Tsumura H, Taira H, et al. Biomechanical study of load transfer of the pubic ramus due to pelvic inclination after hip joint surgery using a three-dimensional finite element model. J Orthop Sci, 2004, 9(3):264-269.
19. Dalstra M, Huiskes R. Load transfer across the pelvic bone. J Biomech, 1995, 28(6):715-724.
20. 榮國威, 王承武. 骨折. 北京:人民衛生出版社, 2004:844-847.
21. 毛賓堯. 人工全髖關節翻修外科的生物力學. 中國矯形外科雜志, 2003, 11(10):672-674.
22. Harris AM, Althausen P, Keiiam JF, et al. Simultaneous anterior and posterior approaches for complex acetabular fractures. J Orthop Trauma, 2008, 22(7):494-497.
23. St?ckle U, Hoffmann R, Nittinger M, et al. Screw fixation of acetabular fractures. Int Orthop, 2000, 24(3):143-147.
24. Dienstknecht T, Müller M, Sellei R, et al. Screw placement in percutaneous acetabular surgery:gender differences of anatomical landmarks in a cadaveric study. Int Orthop, 2013, 37(4):673-679.
25. 穆衛東. 計算機導航引導下骨盆和髖臼骨折微創經皮空心拉力螺釘技術的基礎及應用研究. 濟南:山東大學, 2009.
26. 張秋林, 唐昊, 王秋根, 等. 鎖定加壓重建鋼板在髖臼骨折中的應用. 中華關節外科雜志:電子版, 2008, 2(2):129-133.
27. Harnroongroj T. The role of the anterior column of the acetabulum on pelvic stability:a biomechanical study. Injury, 1998, 29(4):293-296.
28. 王慶賢, 張英澤, 潘進社, 等. 髖臼橫斷骨折不同內固定方式的生物力學研究及臨床意義. 中華創傷骨科雜志, 2005, 7(3):259-262.

Chinese Journal of Reparative and Reconstructive Surgery

BIOMECHANICAL RESEARCH OF DIFFERENT INTERNAL FIXATIONS USING LOCKING RECONSTRUCTION PLATE FOR ACETABULAR TRANSVERSE FRACTURE

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