Does surgically fixation of pubic fracture increase the stability of the operated posterior pelvis?

Bodzay, Tamás; Sztrinkai, Gergely; Pajor, Sándor; Gál, Tamás; Jónás, Zoltán; Erdös, Péter; Váradi, Károly

doi:10.5606/ehc.2014.20

Cited by 12 publications

(11 citation statements)

References 12 publications

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“…Equally, minute sample sizes (Bruna-Rosso et al, 2016;Shi et al, 2014) for validation or non-physiological loading conditions with rigidly-fixed innominate bones (Bruna-Rosso et al, 2016) lower the significance of existing studies, including our own previous findings, as in-silico deformations vary by up to two magnitudes comparing the evident movement to the in-silico models (Hammer et al, 2013;Sichting et al, 2014). Of the 33 computational studies of the pelvis, only seven make an attempt to perform a cadaveric validation in a standardized manner (Anderson et al, 2004;Bodzay et al, 2014;Bruna-Rosso et al, 2016;García et al, 2000;Hammer et al, 2013;Hao et al, 2011;Hu et al, 2017). The remaining majority performs validation based on literature, qualitative description, plastic models or none.…”

Section: Discussionmentioning

confidence: 99%

In-silico pelvis and sacroiliac joint motion—A review on published research using numerical analyses

Hammer

Klima

2019

Clinical Biomechanics

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Section: Discussionmentioning

confidence: 99%

In-silico pelvis and sacroiliac joint motion—A review on published research using numerical analyses

Hammer

Klima

2019

Clinical Biomechanics

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“…Of these, 23 studies utilized the finite elements method (Arkusz et al ; Bodzay et al ; Böhme et al ; Böhme et al ; Bruna‐Rosso et al ; Eichenseer et al ; Fu et al ; García et al ; Hammer et al ; Hao et al ; Hu et al ; Ivanov et al ; Kiapour et al ; Kim et al ; Lei et al ; Lindsey et al , ; Ma et al ; Shi et al ; Sichting et al ; Sztrinkai et al ; Zhang et al ; Zhao et al ), and one used a kinematic simulation approach (Buford et al ). Seven of these studies performed basic science biomechanical analyses (Arkusz et al ; Buford et al ; Eichenseer et al ; Hao et al ; Hu et al ; Shi et al ), whereas pelvic injury and subsequent surgical treatment were the focus of 14 studies (Bodzay et al ; Böhme et al ; Böhme et al ; Bruna‐Rosso et al ; Fu et al ; García et al ; Ivanov et al ; Lei et al ; Lindsey et al , ; Ma et al ; Sztrinkai et al ; Zhang et al ; Zhao et al ). In three studies, numerical experiments were undertaken on the diagnosis and nonsurgical treatment of pelvic pain (Kiapour et al ; Kim et al ; Sichting et al ).…”

Section: Resultsmentioning

confidence: 99%

“…The extent to which anatomical and biomechanical detail of the STL has been included varies vastly between studies. Mostly linear elastic material properties were assigned and commonly as tension‐only spring elements (Arkusz et al ; Bodzay et al ; Böhme et al ; Böhme et al ; Fu et al ; García et al ; Hao et al ; Hu et al ; Lei et al ; Shi et al ; Sichting et al ; Sztrinkai et al ; Zhao et al ). The material properties assigned to the STL vary between 33.2 MPa (Böhme et al ) and 397.0 MPa (Böhme et al ; Hammer et al ), or 0.042 N/mm (García et al ) and 9,000 N/mm (Zhang et al ) for elastic modulus and ligament stiffness, respectively.…”

Section: Resultsmentioning

confidence: 99%

A systematic review of the morphology and function of the sacrotuberous ligament

et al. 2019

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The sacrotuberous ligament (STL) has been linked to conditions such as pelvic girdle pain and pudendal nerve entrapment, yet its contribution to pelvic stability is debated. The purpose of this review was to explore the current understanding of the STL and highlight any gaps in knowledge regarding its anatomy and function. A systematic search of the literature was conducted, focussing on the morphology and attachments of the STL, the relationship of the STL with surrounding structures, and its neurovascular supply and function. A total of 67 papers and four textbooks were obtained. The attachment sites of the STL are largely consistent; however, the extent of its connections with the long head of biceps femoris, gluteus maximus, piriformis, the posterior layer of the thoracolumbar fascia, and sacrospinous ligament are unclear. Morphometric parameters, such as mean STL length (6.4-9.4 cm), depth (0.3-0.4 cm), and width (1.8-3.5 cm, at its midpoint) are variable within and between studies, and little is known about potential side-, age-, or sex-related differences. The STL is pierced in several sites by the inferior and superior gluteal arteries, but information on its innervation pattern is sparse. Functionally, the STL may limit sacral nutation but it appears to have a limited contribution to pelvic stability. Some morphological aspects of the STL warrant further investigation, particularly its connections with surrounding structures, innervation pattern and function. Knowledge of the detailed anatomy and function of this ligament is important to better understanding its role in clinical conditions. Clin. Anat. 32:396-407, 2019.

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“…[10,11] We further developed an anatomically realistic, plastic pelvis model, which we had used in our previous research. [4] After scanning the plastic model, we used CT images to model the different thicknesses of the cortical layers of the bone, but we neglected the role of the cancellous layer, as other authors also did. [5] We used a half-pelvis, more precisely, an ilium bone model.…”

Section: Discussionmentioning

confidence: 99%

“…[4] We modelled an anterior pillar fracture and a T-type fracture on the acetabulum, in which case the pattern of the fracture line ran vertically through the acetabulum and reached the linea terminalis and ran through the obturator foramen as well. Thus it is possible to perform fixation of a T-type fracture with the use of a medially positioned plate alone ( Figure 1).…”

Section: Methodsmentioning

confidence: 99%

Intrapelvic acetabulum surgery: does the positioning of the plate fixation play a role in the stability of the osteosynthesis?

Sztrinkai¹,

Bodzay²,

Madarász³

et al. 2015

Eklem Hastalik Cerrahisi

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The approaches used in the surgical treatment of acetabulum fractures over the past 50 years since the work of Judet et al. [1] have not changed significantly. We use the Kocher-Langenbeck approach to reach the posterior wall, the posterior pillar, or in certain cases of transverse fractures, whereas anterior or dual approaches are used in all other fracture patterns.[1] The gold standard of anterior approaches is the Judet-Letournel ilioinguinal approach. With this approach, one can visualize the anterior pillar and the pelvic brim. Following reduction of the fracture, a cranially positioned plate fixation is applied. The modified Stoppa approach, reported by Hirvensalo [2] in 1993, substantially reduced the invasiveness of the operation. In addition, with this "intrapelvic" acetabulum approach, the quadrilateral ÖZ Amaç: Bu çalışmada plak tespitinin pozisyonlandırılmasının osteosentezin stabilitesinde bir rol oynayıp oynamadığı araştırıldı. Gereç ve yöntemler: Asetabulumun anterior kolon kırığı ve T-tipi kırığının örneklendirilmesi için sonlu elemanlar modeli kullanıldı. Kırık tespiti üç farklı varyasyonda gerçekleştirildi: kraniyal pozisyonlu plak, medial pozisyonlu plak ve iki yöntemin bir kombinasyonu. Kırığı tespit etmek için tüm olgularda plağın iki ucuna 3-3 vidalar yerleştirildi. Bulgular: Her iki kırıkta kraniyal pozisyonlu veya medial pozisyonlu plak kullanıldığında kırık aralığında neredeyse aynı miktarda kayma saptandı ve iki plak eşzamanlı kullanıldığında kayma miktarı daha az değildi. Sonuç: Plak tespitinin pozisyonu osteosentezin stabilitesini etkilememekte ve basit kırık paternlerinde iki plak kullanılan tespit tek bir plaktan daha fazla stabilite sağlamamaktadır.Anahtar sözcükler: Sonlu elemanlar analizi; kırık tespiti; pelvis. ABSTRACT Objectives:This study aims to investigate whether positioning of the plate fixation plays a role in the stability of the osteosynthesis. Materials and methods: We used finite element modelling to model an anterior pillar fracture and a T-type fracture of the acetabulum. Fracture fixation was carried out in three different variations: cranially positioned plate, medially positioned plate, and a combination of the two methods. In all cases, 3-3 screws were inserted on both ends of the plate to fix the fracture. Results: In both fractures, nearly the same amount of displacement was detected in the fracture gap using a cranially positioned or medially positioned plate, and the amount of displacement was not less when using both plates simultaneously. Conclusion: The position of the plate fixation does not affect the stability of the osteosynthesis and in cases of simple fracture patterns, fixation using two plates does not provide more stability than one plate alone.

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Does surgically fixation of pubic fracture increase the stability of the operated posterior pelvis?

Cited by 12 publications

References 12 publications

In-silico pelvis and sacroiliac joint motion—A review on published research using numerical analyses

In-silico pelvis and sacroiliac joint motion—A review on published research using numerical analyses

A systematic review of the morphology and function of the sacrotuberous ligament

Intrapelvic acetabulum surgery: does the positioning of the plate fixation play a role in the stability of the osteosynthesis?

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