There were no failures of either polyaxial screw-plate interface despite large forces and screw angle did not affect the overall strength of these constructs, supporting the biomechanical soundness of both polyaxial device designs under axial loading. However, the POLYAX supported smaller loads compared with the LISS and NCB while under axial loading. In addition, the mode of failure of the NCB plate, creating an intra-articular fracture propagating from the distal posterior screw hole, may be of some concern. Additional testing is needed to determine the clinical importance of the demonstrated differences among these plate designs.
Fixation of unstable zone II sacral fractures using the combination of an iliosacral screw and a locked transsacral screw resists deformation and withstands a greater force to failure as compared to fixation with 2 standard iliosacral screws. This locked transsacral construct may prove advantageous, especially when a percutaneous technique is used for a Type C zone II vertically oriented sacral fracture injury pattern, which can result in residual fracture site separation.
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