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The biomechanical advantages of bilateral lumbo-iliac fixation in unilateral comminuted sacral fractures without sacroiliac screw safe channel: A finite element analysis

BACKGROUND: The aim of this study was to compare the biomechanical characteristics between bilateral and unilateral lumbo-iliac fixation in unilateral comminuted sacral fractures (USF) by finite element analysis. METHODS: A 3-dimensional finite element model of unilateral sacral fractures was simula...

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Autores principales: Song, Wenhao, Zhou, Dongsheng, He, Yu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5059065/
https://www.ncbi.nlm.nih.gov/pubmed/27749563
http://dx.doi.org/10.1097/MD.0000000000005026
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author Song, Wenhao
Zhou, Dongsheng
He, Yu
author_facet Song, Wenhao
Zhou, Dongsheng
He, Yu
author_sort Song, Wenhao
collection PubMed
description BACKGROUND: The aim of this study was to compare the biomechanical characteristics between bilateral and unilateral lumbo-iliac fixation in unilateral comminuted sacral fractures (USF) by finite element analysis. METHODS: A 3-dimensional finite element model of unilateral sacral fractures was simulated. Three kinds of implants were instrumented into the model, including the unilateral lumbopelvic fixation (ULF), bilateral lumbopelvic fixation (BLF), and unilateral iliac fixation with bilateral lumbar pedicle screws (UBF). Loads of compression and rotation were distributed to the superior endplate of L3. To evaluate the biomechanical properties, the construct stiffness, the micromotion of the fractures, the stress distribution of implants, and the balance of hemilumbar vertebra are recorded and analyzed. RESULTS: The highest construct stiffness was provided by BLF. In BLF model, the displacement between iliums was only 0.009 mm (compressional) and 0.001 mm (rotational), which was less than that under normal condition (0.02 mm). The maximum von Misses stress of implants appeared on the UBF. By using unilateral fixation, the L4 endured obvious imbalance on bilateral hemivertebra. A marked difference was exposed in BLF and UBF models, and the equilibrium of stress and activity was shown. CONCLUSION: From the finite element view, the stability of ULF is insufficient to reconstruct the posterior pelvic ring. Furthermore, the unilateral fixation may lead to imbalance of lumbar vertebra and pelvis. On the contrary, the BLF can provide satisfied stability and lumbar balance.
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spelling pubmed-50590652016-11-01 The biomechanical advantages of bilateral lumbo-iliac fixation in unilateral comminuted sacral fractures without sacroiliac screw safe channel: A finite element analysis Song, Wenhao Zhou, Dongsheng He, Yu Medicine (Baltimore) 7100 BACKGROUND: The aim of this study was to compare the biomechanical characteristics between bilateral and unilateral lumbo-iliac fixation in unilateral comminuted sacral fractures (USF) by finite element analysis. METHODS: A 3-dimensional finite element model of unilateral sacral fractures was simulated. Three kinds of implants were instrumented into the model, including the unilateral lumbopelvic fixation (ULF), bilateral lumbopelvic fixation (BLF), and unilateral iliac fixation with bilateral lumbar pedicle screws (UBF). Loads of compression and rotation were distributed to the superior endplate of L3. To evaluate the biomechanical properties, the construct stiffness, the micromotion of the fractures, the stress distribution of implants, and the balance of hemilumbar vertebra are recorded and analyzed. RESULTS: The highest construct stiffness was provided by BLF. In BLF model, the displacement between iliums was only 0.009 mm (compressional) and 0.001 mm (rotational), which was less than that under normal condition (0.02 mm). The maximum von Misses stress of implants appeared on the UBF. By using unilateral fixation, the L4 endured obvious imbalance on bilateral hemivertebra. A marked difference was exposed in BLF and UBF models, and the equilibrium of stress and activity was shown. CONCLUSION: From the finite element view, the stability of ULF is insufficient to reconstruct the posterior pelvic ring. Furthermore, the unilateral fixation may lead to imbalance of lumbar vertebra and pelvis. On the contrary, the BLF can provide satisfied stability and lumbar balance. Wolters Kluwer Health 2016-10-07 /pmc/articles/PMC5059065/ /pubmed/27749563 http://dx.doi.org/10.1097/MD.0000000000005026 Text en Copyright © 2016 the Author(s). Published by Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the Creative Commons Attribution-Non Commercial License 4.0, where it is permissible to download, share and reproduce the work in any medium, provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle 7100
Song, Wenhao
Zhou, Dongsheng
He, Yu
The biomechanical advantages of bilateral lumbo-iliac fixation in unilateral comminuted sacral fractures without sacroiliac screw safe channel: A finite element analysis
title The biomechanical advantages of bilateral lumbo-iliac fixation in unilateral comminuted sacral fractures without sacroiliac screw safe channel: A finite element analysis
title_full The biomechanical advantages of bilateral lumbo-iliac fixation in unilateral comminuted sacral fractures without sacroiliac screw safe channel: A finite element analysis
title_fullStr The biomechanical advantages of bilateral lumbo-iliac fixation in unilateral comminuted sacral fractures without sacroiliac screw safe channel: A finite element analysis
title_full_unstemmed The biomechanical advantages of bilateral lumbo-iliac fixation in unilateral comminuted sacral fractures without sacroiliac screw safe channel: A finite element analysis
title_short The biomechanical advantages of bilateral lumbo-iliac fixation in unilateral comminuted sacral fractures without sacroiliac screw safe channel: A finite element analysis
title_sort biomechanical advantages of bilateral lumbo-iliac fixation in unilateral comminuted sacral fractures without sacroiliac screw safe channel: a finite element analysis
topic 7100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5059065/
https://www.ncbi.nlm.nih.gov/pubmed/27749563
http://dx.doi.org/10.1097/MD.0000000000005026
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