In pelvic fractures, dysfunction of the pelvic ring is often stabilized with supra-acetabular pin insertion. In existing literature, there are heterogeneous indications on proper pins selection and inclinations. Therefore, this study aimed to quantify the narrowing of safe pin corridors in the transverse and sagittal planes with increments of intraosseous screw depths. A computer algorithm created cross-sections over three-dimensional pelvic reconstructions at sagittal inclinations from 45°cranial to 45°caudal in 5°i ncrements. Templates of screw depths spanning 60-120 mm in 15 mm increments were disposed in the transverse plane from 45°medial to 45°lateral. Each intraosseous screw depth and transverse angle were evaluated for intraosseous containment to evaluate ranges narrowing with increasing screw depths. The 60-mm depth resulted in the largest sagittal range (60.9°± 6.9°) and transverse range (27.5°± 4.1°) at 30°caudal. Increasing depths by 15 mm resulted in ranges being significantly different from one another (p < 0.01). The sagittal plane of 20°cranial had the highest frequency of insertion for all depths, while transverse ranges were narrowed (p < 0.01). Bisecting angles were similar for sagittal planes 20°cranial to 30°caudal with an average of 27.9°± 1.2°(p ≥ 0.115). In conclusion, while 60 mm depths can be inserted with the highest discretion, 15 mm increments in depth significantly reduce safe ranges. Screws depths above 90 mm have low frequencies of insertion, should be inserted more cranially and must be considered prone to breaching.

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Objectives: To evaluate the load to failure and meniscus gapping of longitudinal meniscus repairs with Soft Suture Based all-inside devices and compare them to a polyether ether ketone (PEEK) anchored device and inside-out repair. Methods: After IRB review 12 human cadaver knees were dissected leaving only the tibia, the posterior capsule and the medial and lateral menisci with roots still attached to the tibia. This yielded 24 menisci total (12 medial, 12 lateral). Posterior horn longitudinal full thickness meniscus tears were simulated with a scapel and 5mm Mersiline tapes were used to load the repair site. Each knee was randomized to one of 4 meniscus repair groups: Fiberstitch, Juggerstitch, FAST-FIX 360(PEEK), and inside-out with Broadband tape meniscus needles. For each meniscus, 2 longitudinal repairs were performed. The specimens were tested with an Instron imposing 20 cycles between 10N and 30N then the tear gap was measured, followed by a distraction to failure phase after imposing a displacement at a rate of 0.5mm/sec. Results: There There were 6 menisci tested in each of the 4 groups. After low-load cyclical loading, the gaps measured were .63mm, 1.1mm, 1.7mm, and 1.2mm for the Juggerstitch, Fiberstitch, FAST-FIX 360, and Inside-out Groups respectively (see figure 2). The failure load was 352N, 301N, 167N, and 189N for the Juggerstitch, Fiberstitch, FAST-FIX 360, and Inside-out (see figure 3). There was less gap formation and higher load to failure for the Juggerstitch over the FAST-FIX 360 (p=.014 and p=.03, respectively). When comparing all other groups there was no significant difference between groups with respect to gapping or failure load. Conclusions: The Juggerstitch had less gapping at the repair site and a higher failure load than the FAST-FIX 360. The soft suture based All-Inside meniscus repair devices have gapping and failure load comparable or better than traditional repair devices.

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