Cargando…

Parallel analysis of finite element model controlled trial and retrospective case control study on percutaneous internal fixation for vertical sacral fractures

BACKGROUND: Although percutaneous posterior-ring tension-band metallic plate and percutaneous iliosacral screws are used to fix unstable posterior pelvic ring fractures, the biomechanical stability and compatibility of both internal fixation techniques for the treatment of Denis I, II and III type v...

Descripción completa

Detalles Bibliográficos
Autores principales: Chen, Hongwei, Wu, Lijun, Zheng, Rongmei, Liu, Yan, Li, Yang, Ding, Zihai
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3750865/
https://www.ncbi.nlm.nih.gov/pubmed/23879618
http://dx.doi.org/10.1186/1471-2474-14-217
_version_ 1782281489590779904
author Chen, Hongwei
Wu, Lijun
Zheng, Rongmei
Liu, Yan
Li, Yang
Ding, Zihai
author_facet Chen, Hongwei
Wu, Lijun
Zheng, Rongmei
Liu, Yan
Li, Yang
Ding, Zihai
author_sort Chen, Hongwei
collection PubMed
description BACKGROUND: Although percutaneous posterior-ring tension-band metallic plate and percutaneous iliosacral screws are used to fix unstable posterior pelvic ring fractures, the biomechanical stability and compatibility of both internal fixation techniques for the treatment of Denis I, II and III type vertical sacral fractures remain unclear. METHODS: Using CT and MR images of the second generation of Chinese Digitized Human “male No. 23”, two groups of finite element models were developed for Denis I, II and III type vertical sacral fractures with ipsilateral superior and inferior pubic ramus fractures treated with either a percutaneous metallic plate or a percutaneous screw. Accordingly, two groups of clinical cases that were fixed using the above-mentioned two internal fixation techniques were retrospectively evaluated to compare postoperative effect and function. Parallel analysis was performed with a finite element model controlled trial and a case control study. RESULTS: The difference of the postoperative Majeed standards and outcome rates between two case groups was no statistically significant (P > 0.05). Accordingly, the high values of the maximum displacements/stresses of the plate-fixation model group approximated those of the screw-fixation model group. However, further simulation of Denis I, II and III type fractures in each group of models found that the biomechanics of the plate-fixation models became increasingly stable and compatible, whereas the biomechanics of the screw-fixation models maintained tiny fluctuations. When treating Denis III fractures, the biomechanical effects of the pelvic ring of the plate-fixation model were better than the screw-fixation model. CONCLUSIONS: Percutaneous plate and screw fixations are both appropriate for the treatment of Denis I and II type vertical sacral fractures; whereas percutaneous plate fixation appears be superior to percutaneous screw fixation for Denis III type vertical sacral fracture. Biomechanical evidence of finite element evaluations combined with clinical evidence will contribute to our ability to distinguish between indications that require plate or screw fixation for vertical sacral fractures.
format Online
Article
Text
id pubmed-3750865
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-37508652013-08-27 Parallel analysis of finite element model controlled trial and retrospective case control study on percutaneous internal fixation for vertical sacral fractures Chen, Hongwei Wu, Lijun Zheng, Rongmei Liu, Yan Li, Yang Ding, Zihai BMC Musculoskelet Disord Research Article BACKGROUND: Although percutaneous posterior-ring tension-band metallic plate and percutaneous iliosacral screws are used to fix unstable posterior pelvic ring fractures, the biomechanical stability and compatibility of both internal fixation techniques for the treatment of Denis I, II and III type vertical sacral fractures remain unclear. METHODS: Using CT and MR images of the second generation of Chinese Digitized Human “male No. 23”, two groups of finite element models were developed for Denis I, II and III type vertical sacral fractures with ipsilateral superior and inferior pubic ramus fractures treated with either a percutaneous metallic plate or a percutaneous screw. Accordingly, two groups of clinical cases that were fixed using the above-mentioned two internal fixation techniques were retrospectively evaluated to compare postoperative effect and function. Parallel analysis was performed with a finite element model controlled trial and a case control study. RESULTS: The difference of the postoperative Majeed standards and outcome rates between two case groups was no statistically significant (P > 0.05). Accordingly, the high values of the maximum displacements/stresses of the plate-fixation model group approximated those of the screw-fixation model group. However, further simulation of Denis I, II and III type fractures in each group of models found that the biomechanics of the plate-fixation models became increasingly stable and compatible, whereas the biomechanics of the screw-fixation models maintained tiny fluctuations. When treating Denis III fractures, the biomechanical effects of the pelvic ring of the plate-fixation model were better than the screw-fixation model. CONCLUSIONS: Percutaneous plate and screw fixations are both appropriate for the treatment of Denis I and II type vertical sacral fractures; whereas percutaneous plate fixation appears be superior to percutaneous screw fixation for Denis III type vertical sacral fracture. Biomechanical evidence of finite element evaluations combined with clinical evidence will contribute to our ability to distinguish between indications that require plate or screw fixation for vertical sacral fractures. BioMed Central 2013-07-23 /pmc/articles/PMC3750865/ /pubmed/23879618 http://dx.doi.org/10.1186/1471-2474-14-217 Text en Copyright © 2013 Chen et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Chen, Hongwei
Wu, Lijun
Zheng, Rongmei
Liu, Yan
Li, Yang
Ding, Zihai
Parallel analysis of finite element model controlled trial and retrospective case control study on percutaneous internal fixation for vertical sacral fractures
title Parallel analysis of finite element model controlled trial and retrospective case control study on percutaneous internal fixation for vertical sacral fractures
title_full Parallel analysis of finite element model controlled trial and retrospective case control study on percutaneous internal fixation for vertical sacral fractures
title_fullStr Parallel analysis of finite element model controlled trial and retrospective case control study on percutaneous internal fixation for vertical sacral fractures
title_full_unstemmed Parallel analysis of finite element model controlled trial and retrospective case control study on percutaneous internal fixation for vertical sacral fractures
title_short Parallel analysis of finite element model controlled trial and retrospective case control study on percutaneous internal fixation for vertical sacral fractures
title_sort parallel analysis of finite element model controlled trial and retrospective case control study on percutaneous internal fixation for vertical sacral fractures
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3750865/
https://www.ncbi.nlm.nih.gov/pubmed/23879618
http://dx.doi.org/10.1186/1471-2474-14-217
work_keys_str_mv AT chenhongwei parallelanalysisoffiniteelementmodelcontrolledtrialandretrospectivecasecontrolstudyonpercutaneousinternalfixationforverticalsacralfractures
AT wulijun parallelanalysisoffiniteelementmodelcontrolledtrialandretrospectivecasecontrolstudyonpercutaneousinternalfixationforverticalsacralfractures
AT zhengrongmei parallelanalysisoffiniteelementmodelcontrolledtrialandretrospectivecasecontrolstudyonpercutaneousinternalfixationforverticalsacralfractures
AT liuyan parallelanalysisoffiniteelementmodelcontrolledtrialandretrospectivecasecontrolstudyonpercutaneousinternalfixationforverticalsacralfractures
AT liyang parallelanalysisoffiniteelementmodelcontrolledtrialandretrospectivecasecontrolstudyonpercutaneousinternalfixationforverticalsacralfractures
AT dingzihai parallelanalysisoffiniteelementmodelcontrolledtrialandretrospectivecasecontrolstudyonpercutaneousinternalfixationforverticalsacralfractures