Choosing between the Conventional Plates, Locking Plates, or Iliosacral Screws for Sacroiliac Joint Dislocation: A Biomechanical Comparison Study
Abstract
Background: This study examines the comparison of biomechanical strengths of three kinds of the most familiar implants available in Indonesia: conventional and locking sacroiliac plates and screws, also iliosacral screws. Despite the common thought that iliosacral screws are preferred compared to conventional plates and screws due to its biomechanic superiority, this study tested whether the locking plates and screws could offer an alternative.
Materials and Methods: This study was an in vitro experimental study with a Randomized Post Test - Only Control Group Design using pelvic bones from male cadavers aged 20-50 y.o. Twelve samples were divided into three treatment groups and one control group. Group P1 was fixed with two conventional plates, P2 was fixed with two locking plates, P3 was fixed with two iliosacral screws, and control group K with sacroiliac joint was intact. Each group was given an increasing load until a vertical shift of the sacroiliac joint ≥ 2.0 mm was obtained.
Results: The average force load for 2 mm displacement among the fixation systems being tested shows a statistically significant difference (p<0.05). Load failure force for 2 mm displacement in the locking plate and screw group has the highest average (591.33 ± 56.08 N) compared to the iliosacral screw group (583.67 ± 73.56 N) and conventional plate and screw group (574 ± 106.05 N).
Conclusions: Biomechanically, the fixation system using two locking anterior sacroiliac plates and screws is more stable than the iliosacral screws and conventional sacroiliac plates and screws.Keywords
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Khurana B, Sheehan SE, Sodickson AD, Weaver MJ. Pelvic ring fractures: What the orthopedic surgeon wants to know. Radiographics. 2014;34(5):1317–33. doi: 10.1148/rg.345135113
Pan RH, Chang NT, Chu D, Hsu KF, Hsu YN, Hsu JC, et al. Epidemiology of orthopedic fractures and other injuries among inpatients admitted due to traffic accidents: A 10-year nationwide survey in Taiwan. Sci World J. 2014;2014(Ci). doi: 10.1155/2014/637872
Davis D, Foris L, Kane S, Waseem M. Pelvic Fracture [Internet]. StatPearls Publishing. 2020.
van Zwienen CMA, van den Bosch EW, Snijders CJ, Kleinrensink GJ, van Vugt AB. Biomechanical comparison of sacroiliac screw techniques for unstable pelvic ring fractures. J Orthop Trauma. 2004;18(9):589–95. doi: 10.1097/00005131-200410000-00002
Lindahl J, Hirvensalo E. Outcome of operatively treated type-C injuries of the pelvic ring. Acta Orthop. 2005;76(5):667–78. doi: 10.1080/17453670510041754
Ueno FH, Pisani MJ, Machado AN, Rodrigues FL, Fujiki EN, Rodrigues LMR. Biomechanical study of the sacroiliac fracture fixation with titanium rods and pedicle screws. Acta Ortop Bras. 2015;23(3):154–7. doi: 10.1590/1413-78522015230300970
Şahin O, Demirörs H, Akgün RC, Tuncay IC. Internal fixation of bilateral sacroiliac dislocation with transiliac locked plate: A biomechanical study on pelvic models. Acta Orthop Traumatol Turc. 2013;47(6):411–6. doi: 10.3944/AOTT.2013.2840
Zhang L, Peng Y, Du C, Tang P. Biomechanical study of four kinds of percutaneous screw fixation in two types of unilateral sacroiliac joint dislocation: A finite element analysis. Injury. 2014;45(12):2055–9. doi: 10.1016/j.injury.2014.10.052
Chen W, Pan Z jun, Chen J song. Biomechanical research on anterior double-plate fixation for vertically unstable sacroiliac dislocations. Orthop Surg. 2009;1(2):127–31. doi: 10.1111/j.1757-7861.2009.00017.x
Bellini CM, Raimondi MT, Accetta R, Mineo G V. Locked plating: Biomechanics and biology. Tech Orthop. 2007;22(3):167–72. doi: 10.1097/BTO.0b013e31814a6337
DOI: https://doi.org/10.46355/hipknee.v2i1.38
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