Finite element analysis of five internal fixation modes in treatment of Day type Ⅱcrescent fracture dislocation of pelvis / 中国修复重建外科杂志

OBJECTIVE@#To compare the biomechanical differences among the five internal fixation modes in treatment of Day type Ⅱ crescent fracture dislocation of pelvis (CFDP), and find an internal fixation mode which was the most consistent with mechanical principles.@*METHODS@#Based on the pelvic CT data of a healthy adult male volunteer, a Day type Ⅱ CFDP finite element model was established by using Mimics 17.0, ANSYS 12.0-ICEM, Abaqus 2020, and SolidWorks 2012 softwares. After verifying the validity of the finite element model by comparing the anatomical parameters with the three-dimensional reconstruction model and the mechanical validity verification, the fracture and dislocated joint of models were fixed with S 1 sacroiliac screw combined with 1 LC-Ⅱ screw (S 1+LC-Ⅱ group), S 1 sacroiliac screw combined with 2 LC-Ⅱ screws (S 1+2LC-Ⅱ group), S 1 sacroiliac screw combined with 2 posterior iliac screws (S 1+2PIS group), S 1 and S 2 sacroiliac screws combined with 1 LC-Ⅱ screw (S 1+S 2+LC-Ⅱ group), S 2-alar-iliac (S 2AI) screw combined with 1 LC-Ⅱ screw (S 2AI+LC-Ⅱ group), respectively. After each internal fixation model was loaded with a force of 600 N in the standing position, the maximum displacement of the crescent fracture fragments, the maximum stress of the internal fixation (the maximum stress of the screw at the ilium fracture and the maximum stress of the screw at the sacroiliac joint), sacroiliac joint displacement, and bone stress distribution around internal fixation were observed in 5 groups.@*RESULTS@#The finite element model in this study has been verified to be effective. After loading 600 N stress, there was a certain displacement of the crescent fracture of pelvis in each internal fixation model, among which the S 1+LC-Ⅱ group was the largest, the S 1+2LC-Ⅱ group and the S 1+2PIS group were the smallest. The maximum stress of the internal fixation mainly concentrated at the sacroiliac joint and the fracture line of crescent fracture. The maximum stress of the screw at the sacroiliac joint was the largest in the S 1+LC-Ⅱ group and the smallest in the S 2AI+LC-Ⅱ group. The maximum stress of the screw at the ilium fracture was the largest in the S 1+2PIS group and the smallest in the S 1+2LC-Ⅱ group. The displacement of the sacroiliac joint was the largest in the S 1+LC-Ⅱ group and the smallest in the S 1+S 2+LC-Ⅱ group. In each internal fixation model, the maximum stress around the sacroiliac screws concentrated on the contact surface between the screw and the cortical bone, the maximum stress around the screws at the iliac bone concentrated on the cancellous bone of the fracture line, and the maximum stress around the S 2AI screw concentrated on the cancellous bone on the iliac side. The maximum bone stress around the screws at the sacroiliac joint was the largest in the S 1+LC-Ⅱ group and the smallest in the S 2AI+LC-Ⅱ group. The maximum bone stress around the screws at the ilium was the largest in the S 1+2PIS group and the smallest in the S 1+LC-Ⅱ group.@*CONCLUSION@#For the treatment of Day type Ⅱ CFDP, it is recommended to choose S 1 sacroiliac screw combined with 1 LC-Ⅱ screw for internal fixation, which can achieve a firm fixation effect without increasing the number of screws.

Three-dimensional Finite Element Analysis to T-shaped Fracture of Pelvis in Sitting Position / 生物医学工程学杂志

We developed a three-dimensional finite element model of the pelvis. According to Letournel methods, we established a pelvis model of T-shaped fracture with its three different fixation systems, i. e. double column reconstruction plates, anterior column plate combined with posterior column screws and anterior column plate combined with quadrilateral area screws. It was found that the pelvic model was effective and could be used to simulate the mechanical behavior of the pelvis. Three fixation systems had great therapeutic effect on the T-shaped fracture. All fixation systems could increase the stiffness of the model, decrease the stress concentration level and decrease the displacement difference along the fracture line. The quadrilateral area screws, which were drilled into cortical bone, could generate beneficial effect on the T-type fracture. Therefore, the third fixation system mentioned above (i. e. the anterior column plate combined with quadrilateral area screws) has the best biomechanical stability to the T-type fracture.

Finite element modeling and comparison of fixation methods for acetabular fracture with involvement of the quadrilateral plate / 中华创伤杂志

Objective To compared different fixation methods for acetabular fractures involving the quadrilateral plate using a finite element model of the acetabulum.Methods A model of acetabular fractures with quadrilateral plate involved was developed in the finite element software and processed in Hypermesh V10.0 to generate internal fixation with dual-column titanium plate (Group A),anterior special titanium moulding plate plus quadrilateral screws (Group B),and anterior special titanium moulding plate plus quadrilateral screws combined with posterior column screws (Group C).Pelvic stress in sitting and standing positions were simulated in sequence with constraint of tuber nodes and inferior femur.Maximum stress and displacement of the acetabulum and displacement of nodes on fracture lines were measured after a force of 600 N was applied to S1 verterbrae in line with the direction of gravity in sitting and standing positions.Results In sitting position,the maximum stress and displacement of the acetabulum exhibited a sequence of Group C (9.47,1.08) ＜ Group B (19.84,1.11) ＜ Group A (29.73,1.14).Moreover,the same result was found in standing position with Group C (9.62,1.09) ＜ Group B (12.18,1.10) ＜ Group A (13.28,1.13).Mean displacement of nodes on fracture lines ranked in order of Group C ＜ Group B ＜ Group A (P ＞ 0.05).Conclusions The finite element model can reflect the distribution of pelvic stress effectively.Anterior special titanium moulding plate plus quadrilateral screws combined with posterior column screws provide favorable biomechanical stability in treatment of acetabular fractures involving the quadrilateral area.