Berber O, Amis A A, Day A C
St George's Hospital, Blackshaw Road, Tooting, London SW17 0QT, UK.
J Bone Joint Surg Br. 2011 Feb;93(2):237-44. doi: 10.1302/0301-620X.93B2.24567.
The purpose of this study was to assess the stability of a developmental pelvic reconstruction system which extends the concept of triangular osteosynthesis with fixation anterior to the lumbosacral pivot point. An unstable Tile type-C fracture, associated with a sacral transforaminal fracture, was created in synthetic pelves. The new concept was compared with three other constructs, including bilateral iliosacral screws, a tension band plate and a combined plate with screws. The pubic symphysis was plated in all cases. The pelvic ring was loaded to simulate single-stance posture in a cyclical manner until failure, defined as a displacement of 2 mm or 2°. The screws were the weakest construct, failing with a load of 50 N after 400 cycles, with maximal translation in the craniocaudal axis of 12 mm. A tension band plate resisted greater load but failure occurred at 100 N, with maximal rotational displacement around the mediolateral axis of 2.3°. The combination of a plate and screws led to an improvement in stability at the 100 N load level, but rotational failure still occurred around the mediolateral axis. The pelvic reconstruction system was the most stable construct, with a maximal displacement of 2.1° of rotation around the mediolateral axis at a load of 500 N.
本研究的目的是评估一种发育性骨盆重建系统的稳定性，该系统扩展了在腰骶枢轴点前方进行固定的三角形接骨术的概念。在合成骨盆中制造了与骶骨椎间孔骨折相关的不稳定Tile C型骨折。将这一新概念与其他三种结构进行比较，包括双侧髂骶螺钉、张力带钢板和带螺钉的组合钢板。所有病例均对耻骨联合进行钢板固定。对骨盆环进行加载，以周期性方式模拟单腿站立姿势，直至失效，失效定义为位移2毫米或2°。螺钉是最薄弱的结构，在400次循环后，在50牛的载荷下失效，在头尾轴上的最大平移为12毫米。张力带钢板能承受更大的载荷，但在100牛时发生失效，在外中轴周围的最大旋转位移为2.3°。钢板和螺钉的组合在100牛载荷水平下提高了稳定性，但在外中轴周围仍发生旋转失效。骨盆重建系统是最稳定的结构，在500牛的载荷下，在外中轴周围的最大旋转位移为2.1°。
