Different Lengths of Percutaneous Transverse Iliosacral Screw in Geometric Osseous Fixation Pathway: A Finite-Element Analysis

Wu, Qiong; Zhang, Yuanzhi; Wang, Shaobai; Li, Rui; Liu, Gang

doi:10.1007/s43465-022-00656-x

Cited by 3 publications

(2 citation statements)

References 32 publications

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“…When screws are accessed improperly, fracture reduction quality and biomechanical stability are frequently compromised [33]. We investigated the application of preconception planning to simulate screw trajectories and the utilisation of 3D guides to improve the accuracy, safety, and individual comfort of iliosacral screw insertion.…”

Section: Discussionmentioning

confidence: 99%

An investigation to the clinical application of personalized 3D printed guides combined with preoperative virtual iliosacral screws for the management of posterior pelvic ring injury

Zhao,

Liu,

Chen

et al. 2024

Preprint

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Purpose Percutaneous iliosacral screws are difficult to utilise to treat pelvic ring instability injuries, and they usually require navigational or fluoroscopic guidance. The goal of this study is to create a unique 3D-printed guide for iliosacral screw insertion during surgery and evaluate its effectiveness and safety. Methods The same group of surgeons did a retrospective examination of patients who received surgery for an unstable posterior pelvic ring injury at our hospital's trauma centre between January 2020 and May 2023, in accordance with the selection criteria. Patients were categorised into two groups: the conventional surgery (CS) group (n = 17) and the 3D guide plate (GP) group (n = 14), based on the surgical techniques employed, the following variables were documented: Gender, age, cause of injury, sacral dysmorphism, fracture classification, screw insertion time, radiation exposure time for each screw, postoperative screw position grading, follow-up period, and fracture reduction quality. Results The CS group consisted of 17 patients, nine female and eight male, with an average age of 42.6 ± 13.4 years. A total of 14 patients presented with the GP group, consisting of eight females and six males, with an average age of 40.4 ± 13.1. The two groups had no statistically significant differences in sacral dysmorphism, follow-up time, fracture reduction quality, gender, age, cause of injury, or AO fracture classification (p > 0.05). A total of 42 iliosacral screws were inserted in 31 patients: 24 screws in the CS group (18 S1 and 6 S2), and 18 screws in the GP group (14 S1 and 4 S2). In comparison to the CS group, the GP group had substantially lower rates of screw misposition, radiation exposure time per screw, and insertion time per screw (5.56% versus 25.00%; 0.31 ± 0.14min versus 0.91 ± 0.17min; 17.29 ± 1.90min versus 25.18 ± 3.99min). Comparisons between the two groups regarding the duration of radiation exposure for each screw, and the time required to insert each screw were all statistically significant (p < 0.05), however, there was no significant difference in the rate of screw misposition between the two groups (P > 0.05). Conclusion In combination with 3D guide plate technology, the preoperative virtual screw can precisely position the iliosacral screw, thereby introducing a novel technique for percutaneous iliosacral screw placement.

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Section: Discussionmentioning

confidence: 99%

An investigation to the clinical application of personalized 3D printed guides combined with preoperative virtual iliosacral screws for the management of posterior pelvic ring injury

Zhao,

Liu,

Chen

et al. 2024

Preprint

View full text Add to dashboard Cite

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“…Failure of implant fixation usually occurs due to short-term and long-term instability of the bone-implant interface. Implant material properties [1]- [2] implant geometry [3]- [4] and configuration [5]- [7] external loading [8], and interfacial bonding [9] are among the factors that affect the stability of the implant-bone interface.…”

Section: Introductionmentioning

confidence: 99%

Stress Shielding Prediction of Unicortical and Bicortical Screws: A Finite Element Analysis

Djanali¹

2023

JMechE

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The stability in an implant fixation plays a vital role in ensuring proper formation and remodelling process of the fractured bone. Failure in implant fixation is commonly associated with short- and long-term instability of the bone-implant interface. The bone-implant interaction creates a complicated mechanical interplay that might influence the stress distribution and hence the biomechanical performance stability of the implant fixation. Furthermore, implant screw parameters namely thread size, geometrical design and material properties become additional factors that affect the bone-implant interaction. The purpose of this study was to investigate the effect of unicortical and bicortical screws’ parameters on the screw-bone interaction mechanism. To evaluate the stress transfers between screw and bone, the stress parameters namely stress transfer parameters (STP) was employed. A two-dimensional (2D) finite element model of full treaded screw was simulated while varying the parameters of the screw: two types of material (stainless steel A316 and titanium alloy Ti-6Al-4V), screw length and screw pitch. It was found that the lower in elastic modulus results to the higher stress transfer between implant- bone interface. As the titanium have lower elastic modulus, it gave higher values of STP which help to transmit and distribute stress better compared to the stainless steel. While the effect of varying screw pitch between two types of screws shows that STPs values of fully threaded bicortical screws shows significant result for finer pitch size that may advancing bone remodelling process at the early stage.

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Lumbopelvic Stabilization with Two Methods of Triangular Osteosynthesis: A Biomechanical Study

Grüneweller,

Leunig,

Zderic

et al. 2024

JCM

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(1) Background: Pelvic fractures, and particularly instabilities of the dorsal pelvic ring, are becoming increasingly prevalent, particularly in orthogeriatric patients. Spino-pelvic triangular osteosynthesis is an effective approach to achieve sufficient stabilization in vertically unstable fractures. This study compares two types of osteosynthesis: the conventional one and a novel instrumentation where the iliosacral screw is placed through a fenestrated iliac screw. (2) Methods: Sixteen artificial osteoporotic L5+pelvis models with an unstable sacral fracture have been instrumented with either an iliac screw connected with a rod to a L5 pedicle screw and an iliosacral screw (TF) or a fenestrated ilium screw connected with a rod to a L5 pedicle screw and an iliosacral screw passing through the fenestra of the iliac screw (TFS). Biomechanical testing was performed using cyclic loading until failure. (3) Results: Both configurations yielded comparable results with regard to initial stiffness, implant loosening, and cycles to failure. The TFS exhibited markedly higher values for cycles to failure and markedly lower values for loosening. However, due to the characteristics of the artificial bone model, these findings were not significant. (4) Conclusions: The novel triangular fixation systems demonstrated comparable results to the standard triangular osteosynthesis configuration.

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Different Lengths of Percutaneous Transverse Iliosacral Screw in Geometric Osseous Fixation Pathway: A Finite-Element Analysis

Cited by 3 publications

References 32 publications

An investigation to the clinical application of personalized 3D printed guides combined with preoperative virtual iliosacral screws for the management of posterior pelvic ring injury

An investigation to the clinical application of personalized 3D printed guides combined with preoperative virtual iliosacral screws for the management of posterior pelvic ring injury

Stress Shielding Prediction of Unicortical and Bicortical Screws: A Finite Element Analysis

Lumbopelvic Stabilization with Two Methods of Triangular Osteosynthesis: A Biomechanical Study

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