Biomechanical comparison of two stabilization techniques for unstable sacral fractures

J Orthop Sci. 2012 Sep;17(5):574-9. doi: 10.1007/s00776-012-0246-4. Epub 2012 Jun 6.

Abstract

Aim: The purpose of the study was to assess the stability provided by an ilio-iliac dorsal plate fixation technique using an AO narrow DCP on the pelvic brim in vertically and rotationally unstable type-C pelvic ring injuries.

Materials and methods: We examined 12 fresh cadaver pelvises in a single limb stance load. A type-C pelvic ring injury (a type I lateral sacral fracture in the classification of Denis with symphysis pubis rupture) was performed on the cadaver specimen and fixed with a four-hole narrow dynamic compression plate to stabilize the symphysis pubis rupture; the sacrum fracture was stabilized either anteriorly with two 3-hole reconstruction plates ("anterior plate osteosynthesis") or with a posterior fixation using a 12-hole narrow DCP. A cyclic load of between 100 and 250 N was applied to the fifth lumbar vertebra of the specimen. An extensometer was attached to both sides of the sacrum fracture to detect movements at the fracture site.

Results: We were able to achieve usable measurements in nine specimens. Three measurements were performed on each specimen, and the movements recorded at the fracture gap in trans-sacral plate fixation were higher than or similar to those observed for anterior plate synthesis in 23 out of 27 cases.

Conclusion: Dorsal ilio-iliac bridge plate fixation provides somewhat reduced stability compared to anterior plate fixation, but the difference is not significant.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomechanical Phenomena
  • Bone Plates*
  • Cadaver
  • Female
  • Fracture Fixation / methods*
  • Humans
  • Male
  • Middle Aged
  • Sacrum / injuries*
  • Sacrum / surgery*
  • Spinal Fractures / surgery*