Biomechanical evaluation of three kinds of internal fixation methods for acetabular quadrilateral area fracture
Chinese Journal of Clinical Anatomy ›› 2015, Vol. 33 ›› Issue (6) : 690-695.
Biomechanical evaluation of three kinds of internal fixation methods for acetabular quadrilateral area fracture
Objective The purpose of this study was to evaluate the best internal fixation methods of acetabular quadrilateral area fracture. Methods The quadrilateral area fracture models were created by 12 males hemipelves specimens, divided into three groups randomly. The fractures were treated respectively with the following internal fixaction methods, infrapectineal buttress reconstruction plate (group A), infrapectineal buttress locking compression plate (group B), reconstruction plate combined with trans-plate quadrilateral screws(group C). Then the willow leaf films were stuck on the femoral head and vertical compressing loading was continued via the fracture models, followed by measurement of physiological weight 600 N on intact acetabulum in group I(No fracture line was made) and internal fixation of acetabular dome contact characteristics and horizontal and vertical displacements in A, B, C groups. Results Under physiological weight of 600 N, acetabular dome contact characteristics in three groups failed to return to normal, There was a significant difference on the loading area, the mean pressure, the peak pressure, horizontal displacements and longitudinal displacements among groups (P<0.05，besides 200 N). With loads increasing, horizontal displacements and longitudinal displacements were larger，and under 1800 N the longitudinal displacements of group A reached failure criteria. Conclusions For the acetabular quadrilateral area fracture, the internal fixation stability and contact characteristic of reconstruction plate combined with trans-plate quadrilateral screw metho is w better than infrapectineal buttress plate, and it can reduce incidence rate of traumatic arthritis.
[1] Qureshi AA, Archdeacon MT, Jenkins MA, et a1.Infrapectineal plating for acetabular fractures: a technical adjunct to internal fixation[J].J Orthop Trauma.2004,18(3):175-178.
[2] El-khadraweT. A, Hammad A.S, Hassaan A.E. Indicators of outcome after internal fixation of complex acetabular fractures[J].Alexandria Journal of Medicine,2012,2(48):99-107.
[3] Sen R K, Tripathy S K, Aggarwal S, et al. Comminuted quadrilateral plate fracture fixation through the iliofemoral approach[J].Injury,2013,44(2):266-273.
[4] 蔡贤华,刘曦明,汪国栋,等.前路钛板结合方形区螺钉内固定治疗涉及方形区的髋臼骨折[J].中华创伤骨科杂志,2013,15(2):102-106.
[5] Malkani AL1, Voor MJ, et al. Increased Peak Contact Stress after Incongruent Reductionof Transverse Acetabular Fractures: A Cadaveric Model s[J]. J Trauma. 2001,51(4):704-9.
[6] 吴啸波,张奇,郭明珂,等. 髋臼后柱骨折不同方式钢板内固定的稳定性研究[J]. 第三军医大学学报,2010,07:665-668.
[7] Bray TJ, Esser M, Fulkerson L. Osteotomy of the trochanterin open reduction and internal fixation of acetabular fractures[J].J Bone Joint Surg Am,1987,69(5):711-717.
[8] Kistler BJ, Smithson IR, Cooper SA, et al. Are quadrilateral surface buttress plates comparable to traditional forms of transverse acetabular fracture fixation [J]. Clin Orthop Relat Res, 2014, 472(11): 3353-3361.
[9] Yildirim AO, Alemdaroglu KB, Yuksel HY, et al. Finite element analysis of the stability of transverse acetabular fractures in standing and sitting positions by different fixation options[J]. Injury, 2015, 46 Suppl 2: S29-35.
[10]Kaku N, Tsumura H, Taira H, et al. Biomechanical study of load transfer of the pubic ramus due to pelvic inclination after hip joint surgery using a three-dimensional finite element model[J]. J Orthop Sci,2004,9(3):264-269.
[11]Cole J D, Bolhofner B R. Acetabular fracture fixation via a modified Stoppa limited intrapelvic approach. Description of operative technique and preliminary treatment results[J].Clin Orthop Relat Res, 1994,305: 112-123.
[12]Archdeacon M T, Kazemi N, Guy P, et al.The modified Stoppa approach for acetabular fracture[J]. J Am Acad Orthop Surg, 2011,19(3):170-175.
[13]Bible J E, Choxi A A, Kadakia R J, et al. Quantification of bony pelvic exposure through the modified Stoppa approach[J]. J Orthop Trauma,2014,28(6):320-323.
[14]Qureshi AA，Archdeacon MT，Jenkins MA，et a1.Infrapectineal plating for acetabular fractures：a technical adjunct to internal fixation[J].J Orthop Trauma, 2004,18(3):175-178.
[15]Sen R K, Tripathy S K, Aggarwal S, et al. Comminuted quadrilateral plate fracture fixation through the iliofemoral approach[J]. Injury, 2013,44(2):266-273.
[16]Kummer B. The clinical relevance of Biomechanical analysis of the hip area[J]. Zorthop Ihre Grenzgeb,1991,129(4):285-294.
[17]Hak DJ, Hamel AJ,Bay BK,et a.Consequences of transverse acetabular fracture malreduction on load transmission across the hip joint[J].J Orthop Trauma.1998,12 (2):90-100.
[18]王庆贤,张英泽,潘进社,李亚洲,薛静,刘向东,宋朝晖. 髋臼横断骨折不同内固定方法臼顶负重区的应力分布[J].中华创伤杂志,2004,12:43-46.
[19]Vailas JC, Hurwitz S, Wiesel SW. Posterior acetabular fracture dislocations: fragment size， joint capsule and stability[J]. J Trauma,1989,29(11):1494-1496．
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