Department of Orthopedics, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Research Institute of Orthopedics, Zhejiang University, Hangzhou, China.
J Orthop Res. 2023 Aug;41(8):1821-1830. doi: 10.1002/jor.25525. Epub 2023 Jan 31.
The percutaneous sacroiliac (SI) screw is a common fixation option for posterior ring disruption in pelvic fractures. However, SI screw placement is difficult and can injure adjacent neurovascular structures. The sacral-alar-iliac screw (SAI) is a safe, reliable free-hand sacral pelvic fixation technique. To investigate the biomechanical stability of SAI for SI joint dislocation, finite element analysis was performed in unstable Tile-Type B and C pelvic ring injuries. The displacement in S1 (fixation of a unilateral S1 segment with one SI screw), TS1 (fixation of the S1 segment with a transsacra 1 screw), TS2 (fixation of the S2 segment with a transsacra 2 screw), S1AI, and S2AI exceeded the normal SI joint mobility. Sufficient stability after SI joint dislocation was obtained with (TS1 + TS2), (TS2 + S1), (S1AI + S2AI + rod), (S1AI + S2AI), and (S1 + S2AI + S1 pedicle) fixation. The TS1 + TS2 group had the smallest displacement and lowest peak screw stress, followed by (S1 + S2AI + S1 pedicle) placement. Our findings suggest that SAI screws are a valuable option for SI joint dislocation.
经皮骶髂（SI）螺钉是治疗骨盆骨折后后环破裂的常用固定选择。然而，SI 螺钉置入困难，可损伤相邻的神经血管结构。骶髂螺钉（SAI）是一种安全、可靠的徒手骶骨骨盆固定技术。为了研究 SAI 治疗 SI 关节脱位的生物力学稳定性，对不稳定型Tile 型 B 和 C 型骨盆环损伤进行了有限元分析。S1 （单侧 S1 节段用 1 个 SI 螺钉固定）、TS1 （S1 节段用经骶骨 1 螺钉固定）、TS2 （S2 节段用经骶骨 2 螺钉固定）、S1AI 和 S2AI 的 S1 位移超过了正常 SI 关节的活动度。在 SI 关节脱位后，（TS1 + TS2）、（TS2 + S1）、（S1AI + S2AI + 棒）、（S1AI + S2AI）和（S1 + S2AI + S1 椎弓根）固定后获得了足够的稳定性。TS1 + TS2 组的位移最小，螺钉的峰值应力最低，其次是（S1 + S2AI + S1 椎弓根）。我们的研究结果表明，SAI 螺钉是治疗 SI 关节脱位的一种有价值的选择。
