Background

Pelvic fractures in adults are common injuries and account for up to 3.64% of all fractures. Usually, the treatment of open book injuries (Types B1.1 and B1.2 AO-Classification) is open reduction and plate stabilization using dynamic compression plates, with or without interlocking screws. These implants seem to enhance the outcome of such injuries, but also variety of complications occurs. To reduce complications and achieve appropriate reduction and stabilization, this study compared established stabilization techniques to a novel minimally invasive internal fixation method using an internal fixator system that is already being utilized for spinal fractures.

Methods

This study was performed on 32 composite pelvises in a bilateral stance biomechanical model. The pelvises were variously stabilized with an internal fixator, a 4.5 mm dynamic compression plate and a 3.5 mm symphyseal locking dynamic compression plate. The contact area and loading forces were assessed by a sensor film inside the symphyseal gap.

Findings

This study showed significantly greater reduction and loading capabilities of the internal fixator compared to the other implants (p < 0.05). There was also significantly greater contact area with the use of an internal fixator compared to the other implants (p < 0.05). The 3.5 mm interlocking plate showed significantly greater contact area compared to the 4.5 mm plate (p < 0.05).

Interpretation

The internal fixator that is already proven in spinal surgery is biomechanically superior to conventional implants used in pelvic surgery. The contact area analysis furthermore showed a more physiological loading pattern, which can improve ligamentous healing in a clinical context.

中文翻译：

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一种新的耻骨联合书本内固定方法-生物力学分析。

背景

成人骨盆骨折是常见的损伤，占所有骨折的3.64％。通常，对开书伤害（B1.1和B1.2型AO分类）的治疗方法是使用带或不带互锁螺钉的动态压缩板来减少张开并稳定板。这些植入物似乎增强了这种损伤的结果，但是也会发生各种并发症。为了减少并发症并实现适当的复位和稳定，本研究将已建立的稳定技术与一种新型的微创内固定方法进行了比较，该方法使用的内固定系统已经用于脊柱骨折。

方法

这项研究是在双边姿势生物力学模型中对32个复合骨盆进行的。骨盆用内部固定器，4.5 mm动态压迫板和3.5 mm耻骨关节锁定动态压迫板进行各种稳定。接触面积和负载力通过位于干phy间隙内的传感器膜评估。

发现

这项研究表明，与其他植入物相比，内固定器的复位和承载能力明显更高（p <0.05）。与其他植入物相比，使用内部固定器的接触面积也明显更大（p <0.05）。3.5毫米互锁板的接触面积明显大于4.5毫米互锁板（p <0.05）。

解释

在脊柱外科手术中已经被证实的内部固定器在生物力学上优于骨盆手术中使用的传统植入物。接触面积分析还显示了更多的生理负荷模式，在临床情况下可以改善韧带愈合。