Charlotte Arand (Mainz / DE), Christian Hartung (Mainz / DE), Anne Sauer (Mainz / DE), Dorothé Mehler (Mainz / DE), Pol M. Rommens (Mainz / DE), Erol Gercek (Mainz / DE), Philipp Drees (Mainz / DE), Daniel Wagner (Lausanne / CH)
Abstract text (incl. references and figure legends)
Introduction
Minimal invasive stabilization is a common treatment in patients with insufficiency fractures of the pelvic ring. While there is consensus to operatively stabilize the posterior pelvic ring in fractures classified OF3 and higher and in case of persisting immobilizing pain, there is a broad discussion about the significance or potential necessity of an additional fixation of associated fractures of the anterior pelvic ring.
Material & methods:
A standardized FFP IIIc/OF3 fracture was generated in 16 osteoporotic bone models (Fa. Sawbone). All samples were stabilized with a trans sacral bar and an additional fully-threaded SI screw in S1. In one half of the samples the anterior pelvic ring fracture was addressed with a retrograde transpubic screw. The other half was left without anterior stabilization. Each bone model was tested under cyclical axial loading from 25 to 1200 N for 1000 cycles and movement was detected pressure based and visually by separate cameras.
Results:
The bone models with additional anterior stabilization were shown to provide statistically significant higher stability than the samples without anterior fixation (p=0.0014). In both groups new fractures of the sacral ala on the contra lateral side to the initial fracture were observed. In samples without anterior stabilization the new fractures were observed to occur much earlier than in samples with anterior screw fixation.
Conclusion:
Within the present biomechanical model additional fixation of the anterior pelvic ring enhances the stability of the entire pelvic ring relevantly and can prevent or at least constrain occurrence of new fractures or dorsal implant failure.
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