Jin Liang, Hao Xiaorui, Zhang Zhenzhu, Zhang Qiaoli, Zhang Shuxin, Zhou Fei, Yang Shuirong, Zheng Weijie, Xiong Xiaohui, Gong Wanchen, Wang Yukun, Chen Xiaojie, Huang Jiexin
Department of Orthopedic Surgery, Nanping First Hospital Affiliated to Fujian Medical University, Nanping, China.
Department of Clinical Medicine, Fujian Medical University, Fuzhou, China.
Orthop Surg. 2025 May;17(5):1433-1446. doi: 10.1111/os.14291. Epub 2024 Nov 18.
Considering the high incidence and complexity of unstable posterior pelvic ring fractures, and the need for less invasive and more effective treatment options, this study aims to introduce a novel minimally invasive, safe, and simple internal fixation method for the treatment of unstable posterior pelvic ring fractures using the sacroiliac joint locking plate (SJP) system, and to provide biomechanical validation and clinical evaluation of this method.
Biomechanical research was conducted using standard pelvic bone models from Synbone, Switzerland, to create Denis II zone unstable posterior pelvic ring fracture models, and to assess the stability of the SJP under different loads compared with traditional fixation methods. A retrospective clinical study analyzed the clinical efficacy of SJP treatment in 62 patients (mean age of 51.7 ± 11.9 years and male-to-female ratio of 42/20) treated at our hospital from October 2016 to January 2023.
Biomechanical tests showed that at a maximum load of 300 N, the displacement values for the SJP (3.361 ± 0.246 mm) and two iliosacral (IS) screws (3.325 ± 0.335 mm) were significantly lower than those for a single IS screw (4.281 ± 0.399 mm) and tension band plate (TBP) (4.678 ± 0.534 mm). In the stiffness test of the compression-separation experiment, the average stiffness of the SJP (92.09 ± 1.17 N/mm) was higher than that of a single IS screw (80.06 ± 2.57 N/mm) and TBP (71.67 ± 1.12 N/mm) (p < 0.05 for both), but lower than that of two IS screws (104.94 ± 1.16 N/mm) (p < 0.05). Clinically, postoperative pain scores decreased to 1.9 ± 0.9 after SJP surgery, which was a significant reduction compared with the preoperative score of 9.1 ± 1.1. Functional prognosis scores improved from 36.1 ± 11.5 preoperatively to 88.4 ± 14.2, showing a marked improvement. The postoperative Majeed scores for the patients were 87.4 ± 8.1, and the incidence of complications was low, with only one case reported so far.
The SJP demonstrates robust stability in biomechanical experiments, making it highly advantageous for clinical applications and widespread adoption. It offers several benefits, including straightforward surgical operation, minimal risk of vascular and neural injury, low surgical requirements, and eliminates the need for fluoroscopy. These advantages contribute to its remarkable clinical efficacy and potential for extensive utilization.
鉴于不稳定型骨盆后环骨折的高发病率和复杂性，以及对微创且更有效治疗方案的需求，本研究旨在介绍一种使用骶髂关节锁定钢板（SJP）系统治疗不稳定型骨盆后环骨折的新型微创、安全且简单的内固定方法，并对该方法进行生物力学验证和临床评估。
使用来自瑞士Synbone的标准骨盆骨模型进行生物力学研究，以创建Denis II区不稳定型骨盆后环骨折模型，并与传统固定方法相比，评估SJP在不同负荷下的稳定性。一项回顾性临床研究分析了2016年10月至2023年1月在我院接受治疗的62例患者（平均年龄51.7±11.9岁，男女比例为42/20）接受SJP治疗的临床疗效。
生物力学测试表明，在最大负荷为300 N时，SJP（3.361±0.246 mm）和两枚髂骶（IS）螺钉（3.325±0.335 mm）的位移值显著低于单枚IS螺钉（4.281±0.399 mm）和张力带钢板（TBP）（4.678±0.534 mm）。在压缩-分离实验的刚度测试中，SJP的平均刚度（92.09±1.17 N/mm）高于单枚IS螺钉（80.06±2.57 N/mm）和TBP（71.67±1.12 N/mm）（两者p均<0.05），但低于两枚IS螺钉（104.94±1.16 N/mm）（p<0.05）。临床上，SJP手术后患者的术后疼痛评分降至1.9±0.9，与术前评分9.1±1.1相比有显著降低。功能预后评分从术前的36.1±11.5提高到88.4±14.2，有显著改善。患者术后的Majeed评分为87.4±8.1，并发症发生率低，迄今为止仅报告1例。
SJP在生物力学实验中表现出强大的稳定性，使其在临床应用和广泛采用方面具有高度优势。它具有多种益处，包括手术操作简单、血管和神经损伤风险极小、手术要求低，且无需使用荧光透视。这些优势促成了其显著的临床疗效和广泛应用的潜力。
