Effects of minimally invasive plate-screw internal fixation in the treatment of posterior pelvic ring fracture

Li, Shiguang; Meng, Xin; Li, Wenlong; Sun, Zhaoyun; Wang, Xing; Hong-de, QI; Wei, Shuju; Zhou, Dongsheng

doi:10.3892/etm.2018.6670

Cited by 13 publications

(18 citation statements)

References 13 publications

(14 reference statements)

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“…Therefore, we randomly divided the specimens into two groups, and made two kinds of pelvic external rotation injury test models. One group was the hemi-pelvic restricted group (1,3,5,7,9,11,13), the other one was the unrestricted group (2,4,6,8,10,12,14).…”

Section: Experiments Methodsmentioning

confidence: 99%

A biomechanics study about the mechanism of ligaments injury in anterior posterior compression type Ⅱ pelvic injury

Shui

kong

Chu

et al. 2020

Preprint

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Background The anterior and posterior compression (APC) pelvis fracture is a classic pelvic injury, and APC type II is considered to be a typical one caused by the destruction of pelvic ligaments, while the mechanism of ligaments injury and treatment of which is still controversial. This study aims to explore ligaments injury in anterior posterior compression(APC)type II pelvic injury. Method: Fourteen human cadaveric pelvis samples (5 female, 9 male) with the sacrospinous, sacrotuberous, anterior sacroiliac ligaments and partial bone retaining unilaterally were made for this study. To simulate the APC pattern pelvic injury, the samples were divided into two groups randomly, set one group as hemipelvis restricted group (experimental group) and the other one as unrestricted group (control group). According to the biomechanical data, eye observation, motion capture system and real-time video system to record the separation distance of the pubic symphysis and anterior sacroiliac joint, external rotation angle and force when the anterior sacroiliac ligament ruptured. Continuing the external rotation violence, observing the bone and posterior ligaments change since sacrospinous and sacrotuberous ligaments from being damaged to completely ruptured. Result When anterior sacroiliac ligament failed, the mean separation distance of pubic symphysis and anterior sacroiliac joint between restricted group and unrestricted group was 28.6 ± 8.4 mm to 23.6 ± 8.2 mm(P = 0.11) and 11.4 ± 3.8 mm to 9.7 ± 3.9 mm (P = 0.30) respectively. In addition, the external rotation angle and force was 33.9 ± 5.5° to 48.9 ± 5.2°(P < 0.01) and 553.9 ± 82.6 N to 756.6 ± 41.4 N (P < 0.01) respectively. The two distances were not significantly different (P > 0.05), however, the external rotation angle and violence was significantly different (P < 0.05), which was bigger in the unrestricted group. In the unrestricted group, when anterior sacroiliac ligament ruptured, no distinct sacrospinous or sacrotuberous ligaments injury was observed, but in the restricted group, all of samples had two ligaments injury and even two samples had ligaments failed. Moreover, with the extreme external rotation violence continuing, there was still no sacrospinous or sacrotuberous ligaments injury in the unrestricted group. But interosseous sacroiliac ligament, posterior sacroiliac ligaments injury and slight sagittal rotation and sacroiliac joint displacement appeared. In the control group, the sacrospinous ligament ruptured firstly and then the sacrotuberous ligament ruptured. When both of the two ligaments failed, the interosseous sacroiliac ligament was damaged while posterior ligament was not. In the restricted group, when all of the anterior sacroiliac ligament, sacrospinous ligament or sacrotuberous ligament failed, mean separation distance of pubic symphysis and anterior sacroiliac joint increased significantly (from 28.6 ± 8.4 to 42.0 ± 7.6 mm, 11.4 ± 3.8 to 16.7 ± 4.2 mm respectively, all P < 0.05). Conclusion We have three main findings: First, pelvic external rotation injury can divide into two situations: hemipelvis is restricted and unrestricted, which result into two different outcomes. When anterior sacroiliac ligament rupture, the unrestricted group needs more external rotation angle and force, without obvious sacrotuberous or sacrospinous ligaments injury. But in the restricted group, both of two ligaments injury appear. Second, when anterior sacroiliac ligament fail, pubic symphysis displacement ranges from 14 to 40 mm, which has a high fluctuation. Third, when the anterior sacroiliac ligament is damaged, we dose not observe the inevitable destruction of the pelvic floor ligaments (sacrospinous ligament and sacrotubercular ligament).

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Section: Experiments Methodsmentioning

confidence: 99%

A biomechanics study about the mechanism of ligaments injury in anterior posterior compression type Ⅱ pelvic injury

Shui

kong

Chu

et al. 2020

Preprint

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“…Therefore, we stimulated and modi ed two different APC injury models that based on the articles reported in recent years [7], and randomly divided the specimens into two groups, and made two kinds of pelvic external rotation injury test models. One group was the hemipelvic restricted group (1,3,5,7,9,11,13), the one was the unrestricted group (2,4,6,8,10,12,14). In both the groups, 3-4 steel K-wires with a diameter of 1 cm were inserted into the pelvis from the middle of the fth lumbar vertebrae to the center of the sacrum, and then the pelvis was embedded with a xator to provide the axial load.…”

Section: Experiments Methodsmentioning

confidence: 99%

A biomechanics study on ligamentous injury in anterior posterior compression type II pelvic injury

Kong

Chu

Zhou

et al. 2020

Preprint

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Background: Anterior posterior compression (APC) type II pelvis fracture is caused by the destruction of pelvic ligaments. This study aims to explore ligaments injury in APC type II pelvic injury.Method: Fourteen human cadaveric pelvis samples with sacrospinous ligament (SPL), sacrotuberous ligament (SBL), anterior sacroiliac ligament (ASL), and partial bone retaining unilaterally were acquired for this study. They were randomly divided into hemipelvis restricted and unrestricted groups. We recorded the separation distance of the pubic symphysis and anterior sacroiliac joint, external rotation angle, and force when ASL ruptured. We observed the external rotation damage to the pelvic bone and ligaments.Result: When ASL failed, there was no significant difference in pubic symphysis separation (28.6 ± 8.4 mm to 23.6 ± 8.2 mm, P = 0.11) and anterior sacroiliac joint separation (11.4 ± 3.8 mm to 9.7 ± 3.9 mm, P = 0.30) between restricted and unrestricted groups. The external rotation angle (33.9 ± 5.5° to 48.9 ± 5.2°, P < 0.01) and force (553.9 ± 82.6 N to 756.6 ± 41.4 N, P < 0.01) were significantly different. Pubic symphysis separation between two groups ranged from 14 mm to 40 mm. In the restricted group, both SBL and SPL were injured. SPL ruptured first, and then SBL and the interosseous sacroiliac ligament were damaged while the posterior ligament remained unharmed. In the unrestricted group, interosseous sacroiliac ligament and posterior sacroiliac ligaments were damaged, while SBL and SPL were not. When the ASL, SBL, and SPL all failed, pubic symphysis and anterior sacroiliac joint separation between two groups increased significantly (from 28.6 ± 8.4 to 42.0 ± 7.6 mm, 11.4 ± 3.8 to 16.7 ± 4.2 mm respectively, all P < 0.05).Conclusion: Pelvic external rotation injury is either hemipelvic restricted or unrestricted, which can result in different outcomes. When the ASL ruptures, the unrestricted group needs greater external rotation angle and force, without SBL or SPL injury, while both SBL and SPL were injured in another group. When ASL fails in two groups, pubic symphysis separation fluctuates considerably. Finally, when the ASL ruptures, SBL and SPL may be undamaged.

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“…Результатами использования способов малоинвазивной фиксации являются минимальная кровопотеря, уменьшение длительности оперативного вмешательства, щадящее воздействие на мягкие ткани, снижение частоты развития осложнений, быстрый регресс болевого синдрома. Использование малоинвазивных перкутанных методов остеосинтеза позволяет значительно улучшить клинико-функциональные результаты лечения больных с повреждениями тазового кольца, уменьшить риск осложнений в послеоперационном периоде и сократить сроки пребывания больных в стационаре [22]. Предложенный в настоящей статье способ с доступными имплантатами и использованием относительно простой хирургической техники позволяет быстро и эффективно обеспечивать фиксацию при переломах лонных костей в зонах Nakatani I и II.…”

Section: приводим клинические наблюденияunclassified

Potentialities of low invasive fixation of the anterior pelvic ring with threaded pin

Solod

Lazarev

Petrovskiy

et al. 2018

N.N. Priorov Journal of Traumatology and Orthopedics

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2 Городская клиническая больница им. А.К. Ерамишанцева, Москва, РФ; 3 ФГБУ «Национальный медицинский исследовательский центр травматологии и ортопедии им. Н.Н. Приорова» Минздрава России, Москва, РФ; 4 ГБУЗ КО «Калужская областная клиническая больница скорой медицинской помощи им. К.Н. Шевченко», Калуга, Россия Цель исследования: представить первый опыт использования способа фиксации переломов лонных костей с помощью спиц с нарезкой и возможности его применения в практике.

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Effects of minimally invasive plate-screw internal fixation in the treatment of posterior pelvic ring fracture

Cited by 13 publications

References 13 publications

A biomechanics study about the mechanism of ligaments injury in anterior posterior compression type Ⅱ pelvic injury

A biomechanics study about the mechanism of ligaments injury in anterior posterior compression type Ⅱ pelvic injury

A biomechanics study on ligamentous injury in anterior posterior compression type II pelvic injury

Potentialities of low invasive fixation of the anterior pelvic ring with threaded pin

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