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四种单侧垂直骶骨骨折三角骨固定术的生物力学比较。

Biomechanical comparison of four triangular osteosynthesis fixations for unilateral vertical sacral fractures.

机构信息

Orthopaedics Department, Yantai Shan Hospital, 91#, Jiefang Road, Yantai, 264008, Shandong Province, People's Republic of China.

Yantai Key Laboratory for Repair and Reconstruction of Bone & Joint, Yantai Shan Hospital, Yantai, People's Republic of China.

出版信息

Sci Rep. 2023 Mar 17;13(1):4424. doi: 10.1038/s41598-023-31418-w.

Abstract

To compare the stability and biomechanical characteristics of four commonly used triangular osteosynthesis techniques to treat unilateral vertical sacral fractures and provide a clinical application reference. Finite element models of Tile C-type pelvic ring injury (unilateral Denis II sacral fracture) were produced. In four models, sacral fractures were fixed with a combination of unilateral L5, unilateral L4, and L5 iliac lumbar fixation with lengthened or normal sacroiliac screws. The biomechanical properties of the four fixation models were measured and compared under bipedal stance and lumbar rotation. The fixation stability of the model with the lengthened sacroiliac screw was excellent, and the fracture end was stable. The stability of fixation using unilateral L4 and L5 segments was close to that of unilateral L5 segment fixation. Triangular osteosynthesis transverse stabilization devices using lengthened sacroiliac screws can increase the vertical stability of the sacrum after internal fixation and increase the stability of the fracture. When triangular osteosynthesis lumbar fixation segments were selected, simultaneous fixation of L4 and L5 segments versus only L5 segments did not significantly enhance the vertical stability of the sacrum or the stability of the fracture end.

摘要

为了比较四种常用的三角骨外固定技术治疗单侧垂直骶骨骨折的稳定性和生物力学特性,为临床应用提供参考。制作了 Tile C 型骨盆环损伤(单侧 Denis II 骶骨骨折)的有限元模型。在四个模型中,采用单侧 L5、单侧 L4 和 L5 髂腰固定结合延长或正常骶髂螺钉固定骶骨骨折。在双足站立和腰椎旋转两种体位下,测量和比较了四种固定模型的生物力学性能。采用延长骶髂螺钉固定的模型固定稳定性极佳,骨折端稳定。单侧 L4 和 L5 节段固定的稳定性接近单侧 L5 节段固定。使用延长骶髂螺钉的三角骨外固定横向稳定装置可以增加内固定后骶骨的垂直稳定性,并增加骨折的稳定性。在选择三角骨外固定腰椎固定节段时,L4 和 L5 节段同时固定与仅 L5 节段固定相比,并不会显著增强骶骨的垂直稳定性或骨折端的稳定性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3153/10023656/b240eb9484ef/41598_2023_31418_Fig1_HTML.jpg

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