Does surgically fixation of pubic fracture increase the stability of the operated posterior pelvis?
Tamás Bodzay1, Gergely Sztrinkai1, Sándor Pajor1, Tamás Gál2, Zoltán Jónás3, Péter Erdös4, Károly Váradi4
1Trauma Centre, Péterfy Hospital, Budapest, Hungary
2Department Trauma, Semmelweis University, Budapest, Hungary
3Department of Orthopaedic Surgery, University of Debrecen, Medical and Health Centre, Debrecen, Hungary
4Faculty of Mechanical Engineering, Institute of Machine Design, University of Technology and Economics, Budapest, Hungary
Keywords: Finite element analysis; pelvic ring; pubic fracture; pubic plate; retrograde pubic screw.
Abstract
Objectives: This study aims to investigate whether surgical treatment of pubic rami fractures increases the stability of the posterior pelvis. Material and methods: A finite element pelvic model with improved geometric and material characteristics was analyzed. By imitating a standing position, a type I Denis sacrum fracture and a unilateral pubis fracture, we measured the differences in tension and displacement. The posterior injury was treated with a direct plate synthesis or transsacral plate synthesis, while the pubis fracture was left without fixation or fixed with either a retrograde pubic screw or plate synthesis.
Results: The operative fixation of pubic rami fractures decreased the movement in the fracture gap not only at the site of the pubis fracture, but also at the site of the fixed sacrum fracture. The plate synthesis provided greater stability of the anterior fracture than the retrograde screw. The tensions in the implants were below the allowed values.
Conclusion: We concluded that surgically fixation of pubic fracture increases the stability of the operated posterior pelvis.