Biomechanical analysis of stiffness and fracture displacement after using PMMA-augmented sacroiliac screw fixation for sacrum fractures

被引:22
作者
Hoech, Andreas [1 ]
Schimpf, Richard [1 ]
Hammer, Niels [2 ]
Schleifenbaum, Stefan [1 ]
Werner, Michael [3 ]
Josten, Christoph [1 ]
Boehme, Joerg [1 ]
机构
[1] Univ Leipzig, Dept Orthopaed Trauma & Plast Surg, Liebigstr 20, D-04103 Lepizig, Germany
[2] Univ Otago, Dept Anat, Lindo Ferguson Bldg,270 Great King St, Dunedin 9016, New Zealand
[3] Fraunhofer Inst Machine Tools & Forming Technol I, Nothnitzer Str 44, D-01187 Dresden, Germany
来源
BIOMEDICAL ENGINEERING-BIOMEDIZINISCHE TECHNIK | 2017年 / 62卷 / 04期
关键词
biomechanical analysis; fragility fracture; osteoporosis; pelvic fracture; PMMA; sacroiliac screw fixation; PELVIC RING FRACTURES; INTERNAL-FIXATION; ILIOSACRAL SCREW; INSUFFICIENCY FRACTURES; CEMENT; CLASSIFICATION; STABILITY;
D O I
10.1515/bmt-2016-0235
中图分类号
R318 [生物医学工程];
学科分类号
0831 ;
摘要
Cement augmentation of pedicle screws is the gold standard for the stabilization of osteoporotic fractures of the spine. In-screw cement augmentation, in which cement is injected through the cannula, is another option for fracture stabilization of fragility fractures of the sacrum. However, biomechanical superiority of this technique compared to conventional sacroiliac screw fixation has not been tested. The present study compares the stability of cement-augmented and non-cement-augmented sacroiliac screw fixation in osteoporotic sacrum fractures under cyclic loading. Eight human donor pelvises with intact ligaments and 5th lumbar vertebra were dissected. A vertical shear fracture was created as a combination of a sacrum fracture and cutting of the symphysis. Both sides were tested in a single-limb-stance setup with 10,000 loading cycles applied. Stiffness of the pelvis and displacement of the fracture were measured using a hydraulic testing machine and a 3D image correlation system. The augmented screw fixation failed in two of eight pelvises, and the non-augmented screws failed in three of eight pelvises. CT scans showed no leakage of cement. In-screw polymethylmethacrylate (PMMA) augmentation showed no advantage based on measured displacement of the sacrum fractures or stiffness for sacroiliac screw fixation of fragility fractures of the sacrum.
引用
收藏
页码:421 / 428
页数:8
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