Wu Tao, Su Ke, Zhang Ying-Ze, Yang Zong-You, Li Hui-Jie, Han Yong-Tai
Technol Health Care. 2019;27(1):89-99. doi: 10.3233/THC-181274.
Although there are several different kinds of fixation techniques for the sacroiliac fracture-dislocation, the treatment remains a challenge for orthopedic surgeons.
The purpose of this study was to compare the stability of sacroiliac fracture-dislocation fixed with two iliosacral (IS) screws, tension band plate (TBP), and minimally invasive adjustable plate (MIAP).
Five human cadavers (L4-pelvic-femora) were used to compare biomechanical stability. The pubic symphysis separation and left sacroiliac dislocation were created. The symphysis pubis was stabilized with a five-hole plate. The sacroiliac joint dislocation fracture was fixed with three kinds of internal fixation in a randomized design. The specimens were fastened in a biomechanical machine with a cycle vertical load. Displacements of the whole specimen and shifts in the fracture gap were recorded.
Under different vertical loads, the shifts in the fracture gap and the displacements of the pelvis fixed with MIAP were similar to those in fractures fixed with two IS screws. However, the shifts in the fracture gap and the displacements of the pelvis fixed with MIAP were significantly smaller than those fixed with TBP.
The stability of the sacroiliac joint dislocation fixed with MIAP was similar to that of dislocation fixed with two IS screws, and MIAP performed better than the TBP under vertical load.
尽管骶髂关节骨折脱位有多种不同的固定技术，但该治疗方法对骨科医生来说仍然是一项挑战。
本研究旨在比较使用两枚髂骶螺钉、张力带钢板（TBP）和微创可调钢板（MIAP）固定骶髂关节骨折脱位的稳定性。
使用5具人尸体（L4 - 骨盆 - 股骨）比较生物力学稳定性。制造耻骨联合分离和左侧骶髂关节脱位。用一块五孔钢板固定耻骨联合。骶髂关节脱位骨折采用三种内固定方式进行随机设计固定。将标本固定在生物力学机器上施加循环垂直载荷。记录整个标本的位移和骨折间隙的移位情况。
在不同垂直载荷下，MIAP固定的骨折间隙移位和骨盆位移与两枚髂骶螺钉固定的骨折相似。然而，MIAP固定的骨折间隙移位和骨盆位移明显小于TBP固定的情况。
MIAP固定骶髂关节脱位的稳定性与两枚髂骶螺钉固定的脱位相似，且在垂直载荷下MIAP的表现优于TBP。
