PDF(Pubmed)
Abstract：
Background and Objectives: Acetabular fractures, though infrequent, present considerable challenges in treatment due to their association with high-energy trauma and poor prognoses. Posterior wall fractures, the most common type among them, typically have a more favorable prognosis compared to other types. Anatomical reduction and stable fixation of the posterior wall are crucial for optimal treatment outcomes. This study aimed to biomechanically compare three commonly used fixation methods for posterior wall fractures of the acetabulum-a conventional reconstruction plate, a spring plate, and a 2.7 mm variable angle locking compression plate (VA-LCP). Materials and Methods: The study utilized 6 fresh-frozen cadavers, yielding 12 hemipelvises free from prior trauma or surgery. Three fixation methods were compared using a simple acetabulum posterior wall fracture model. Fixation was performed by an orthopedic specialist, with prebending of plates to minimize errors. Hemipelvises were subjected to quasi-static and cyclic loading tests, measuring fracture gap, stiffness, and displacement under load. Results: It showed no significant differences in fracture gap among the three fixation methods under cyclic loading conditions simulating walking. However, the conventional reconstruction plate exhibited a greater stiffness compared to the spring and variable angle plates. Fatigue analysis revealed no significant differences among the plates, indicating a similar stability throughout cyclic loading. Despite differences in stiffness, all three fixation methods demonstrated adequate stability under loading conditions. Conclusions: While the conventional reconstruction plate demonstrated a superior stiffness, all three fixation methods provided sufficient stability under cyclic loading conditions similar to walking. This suggests that postoperative limitations are unlikely with any of the three methods, provided excessive activities are avoided. Furthermore, the variable angle plate-like the spring plate-offers an appropriate stability for fragment-specific fixation, supporting its use in surgical applications. These findings contribute to understanding the biomechanical performance of different fixation methods for acetabular fractures, facilitating improved surgical outcomes in challenging cases.
摘要：
背景和目的:髋臼骨折,虽然不常见，由于它们与高能量创伤和不良预后相关，因此在治疗方面存在相当大的挑战。后壁骨折,其中最常见的类型，与其他类型相比，通常具有更有利的预后。解剖复位和后壁的稳定固定对于最佳治疗效果至关重要。本研究旨在对髋臼后壁骨折的三种常用固定方法——常规重建钢板进行生物力学比较。一个弹簧板，和2.7mm可变角度锁定压缩板(VA-LCP)。材料和方法：本研究利用6具新鲜冷冻尸体，产生12个无先前创伤或手术的半骨盆。使用简单的髋臼后壁骨折模型比较了三种固定方法。固定是由骨科专家进行的，预弯的板，以尽量减少误差。对半骨盆进行了准静态和循环载荷测试，测量断裂间隙,刚度,和负载下的位移。结果：在模拟步行的循环载荷条件下，三种固定方法之间的骨折间隙没有显着差异。然而,与弹簧和可变角度板相比，传统的重建板具有更大的刚度。疲劳分析显示板之间没有显着差异，表明在整个循环加载过程中具有相似的稳定性。尽管刚度不同，所有三种固定方法在负载条件下都表现出足够的稳定性。结论：虽然传统重建钢板表现出优越的刚度，在类似于步行的循环载荷条件下，所有三种固定方法都提供了足够的稳定性。这表明三种方法中的任何一种都不太可能存在术后局限性，如果避免过多的活动。此外，可变角度板-像弹簧板-提供了一个适当的稳定性碎片特定的固定，支持其在外科应用中的使用。这些发现有助于了解髋臼骨折不同固定方法的生物力学性能。在具有挑战性的病例中促进改善手术结果。
