Objective: The aim of this study was to evaluate the biomechanical properties of commonŞxation systems for complex acetabular fractures.Methods: AŞnite element (FE) pelvic model with anterior column and posterior hemi-transverseacetabular fractures was created. Three commonŞxation systems were used to Şx the posterior wallacetabular fractures: 1. Anterior column plate combined with posterior column screws (group I), 2.Anterior column plate combined with quadrilateral area screws (group II) and 3. Double-column plates(group III). And 600 N, representing the body weight, was loaded on the upper surface of the sacrum tosimulate the double-limb stance. The amounts of total and relative displacements were compared between the groups.Results: The total amount of displacement was 2.76 mm in group II, 2.81 mm in group III, and 2.83 mm ingroup I. The amount of relative displacement was 0.0078 mm in group II, 0.0093 mm in group III and0.014 mm in group I.Conclusion: Our results suggested that allŞxation systems enhance biomechanical stability signiŞcantly.Anterior column plate combined with quadrilateral area screws has quite comparable results to doublecolumn plates, they were superior to anterior column plate combined with posterior screws.
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1. Moed BR, WillsonCarr SE, Watson JT. Results of operative treatment of fractures of the posterior wall of the acetabulum. J Bone Jt Surg. 2002;84(5):752e758.
2. Matta JM. Operative treatment of acetabular fractures through the ilioinguinal approach e a 10-year perspective. Clin Orthop Relat Res. 1994;305:10e19.
3. Lin HH, Hung SH, Su YP, Chiu FY, Liu CL. Cerclage wiring in displaced associated anterior column and posterior hemi-transverse acetabular fractures. Injury. 2012;43(6):917e920.
4. Cole JD, Bolhofner BR. Acetabular fracture fixation via a modified stoppa limited intrapelvic approach description of operative technique and preliminary treatment results. Clin Orthop Relat Res. 1994;305:112e123.
5. Martinez CR, Di Pasquale TG, Helfet DL, Graham AW, Sanders RW, Ray LD. Evaluation of acetabular fractures with two-and three-dimensional CT. Radiographics. 1992;12(2):227e242.
6. Anderson AE, Peters CL, Tuttle BD, Weiss JA. Development and validation of a subject-specific finite element model of the pelvis: assessment of model sensitivity. In: Proceedings of Computer Methods in Biomechanics and Biomedical Engineering. Madrid: FIRST Numerics; 2004. ISBN 0-9549670-0-3.
7. Sawaguchi T, Brown TD, Rubash HE, Mears DC. Stability of acetabular fractures after internal fixation: a cadaveric study. Acta Orthop. 1984;55(6):601e605.
8. Wolf H, Wieland T, Pajenda G, Vecsei V, Mousavi M. Minimally invasive ilioinguinal approach to the acetabulum. Injury. 2007;38(10):1170e1176.
9. Yildirim AO, Alemdaroglu KB, Yuksel HY, Oken € OF, Ucaner A. Finite element € analysis of the stability of transverse acetabular fractures in standing and sitting positions by different fixation options. Injury. 2015;46:S29eS35.
10. Pierannunzii L, Fischer F, Tagliabue L, Calori GM, D'Imporzano M. Acetabular both-column fractures: essentials of operative management. Injury. 2010;41(11):1145e1149.
11. Wu Y, Cai X, Liu X, Zhang H. Biomechanical analysis of the acetabular buttressplate: are complex acetabular fractures in the quadrilateral area stable after treatment with anterior construct plate-1/3 tube buttress plate fixation? Clinics. 2013;68(7):1028e1033.
12. Dalstra M, Huiskes R. Load transfer across the pelvic bone. J Biomech. 1995;28(6):715e724.
13. Gettys FK, Russell GV, Karunakar MA. Open treatment of pelvic and acetabular fractures. Orthop Clin N Am. 2011;42(1):69e83.
14. Zhang Y, Zhao X, Tang Y, Zhang C, Xu S, Xie Y. Comparative study of comminuted posterior acetabular wall fracture treated with the Acetabular Tridimensional Memory Fixation System. Injury. 2014;45(4):725e731.
15. Brolin K, Halldin P. Development of a finite element model of the upper cervical spine and a parameter study of ligament characteristics. Spine (Phila Pa 1976). 2004;29(4):376e385.
16. Zhang QH, Teo EC, Ng HW, Lee VS. Finite element analysis of moment-rotation relationships for human cervical spine. J Biomech. 2006;39(1):189e193.
17. Olson SA, Bay BK, Pollak AN, Sharkey NA, Lee T. The effect of variable size posterior wall acetabular fractures on contact characteristics of the hip joint. J Orthop Trauma. 1996;10(6):395e402.
18. Andersen RC, O'Toole RV, Nascone JW, Sciadini MF, Frisch HM, Turen CW. Modified stoppa approach for acetabular fractures with anterior and posterior column displacement: quantification of radiographic reduction and analysis of interobserver variability. J Orthop Trauma. 2010;24(5):271e278.
19. Phillips A, Pankaj P, Howie CR, Usmani AS, Simpson A. Finite element modelling of the pelvis: inclusion of muscular and ligamentous boundary conditions. Med Eng Phys. 2007;29(7):739e748.
20. Dalstra M, van Erning L, Huiskes R. Development and validation of a threedimensional finite element model of the pelvic bone. J Biomech Eng. 1995;117(3):272e278.
21. Briffa N, Pearce R, Hill AM, Bircher M. Outcomes of acetabular fracture fixation with ten years' follow-up. J Bone Jt Surg Br Vol. 2011;93(2):229e236.
22. Gililland JM, Anderson LA, Henninger HB, Kubiak EN, Peters CL. Biomechanical analysis of acetabular revision constructs: is pelvic discontinuity best treated with bicolumnar or traditional unicolumnar fixation? J Arthroplast. 2013;28(1): 178e186.
23. Schopfer A, DiAngelo D, Hearn T, Powell J, Tile M. Biomechanical comparison of methods of fixation of isolated osteotomies of the posterior acetabular column. Int Orthop. 1994;18(2):96e101.
24. Kubota M, Uchida K, Kokubo Y, et al. Changes in gait pattern and hip muscle strength after open reduction and internal fixation of acetabular fracture. Arch Phys Med Rehabil. 2012;93(11):2015e2021.
25. Wu T, Chen W, Zhang Q, et al. Biomechanical comparison of two kinds of internal fixation in a type C zone II pelvic fracture model. Chin Med J Engl. 2015;128(17):2312e2317.
26. Harnroongroj T, Asavamongkolkul A, Chareancholvanich K. Reconstruction of the pelvic brim and its role in the reduction accuracy of displaced T-shaped acetabular fracture. J Med Assoc Thai. 2000;83(5):483e493.