Finite element comparative study of S2 alar-iliac screw and sacroiliac joint screw in treatment of type C sacroiliac joint dislocation / 中华创伤杂志

ABSTRACT

Objective To compare the biomechanical characteristics between S2 alar-iliac (S2AI) screw and sacroiliac joint screw in treating unilateral type C sacroiliac joint dislocation. Methods A 25 year-old healthy male adult agreed to take computed tomography scan of the pelvis. The pelvic floor thickness was 1 mm and the image data were saved in DCOM format. A three dimensional finite element model of intact pelvis was reconstructed by Mimics, Geomagic, SolidWorks, and Abaqus softwares. A finite element model of type C unilateral sacroiliac dislocation was established. One S1 vertebral sacroiliac screw of 6.5 mm in diameter (S1 group), one S2AI screw (S2AI group) and one Si vertebra sacroiliac screw + one S2 vertebra sacroiliac screw (S1+S2 group) were placed in the model, respectively. The500 N vertical load on the upper surface of the sacrum was simulated. The displacement value of sacroiliac joint, the displacement of sacrum, the stress value of the internal fixation and surrounding bone, and the stress distribution cloud map were recorded and analyzed. Results The displacement data showed that displacement distribution in the three groups had a consistent trend. In terms of the absolute value of displacement the result was S, group＞S 2AI group＞S1+ S2 group, of which the maximum displacement of sacroiliac joint in S1 groups was 0.87 mm and that of sacrum was 1.6 mm; the maximum displacement of sacroiliac joint in S2 AI group was 0.22 mm, and that of sacrum was 0.24 mm; the maximum displacement of the sacroiliac joint in S1 + S2 group was 0.06 mm, and that of sacrum was0.16 mm. Stress data showed that the stress in the internal fixation was mainly distributed at the sacroiliac joint, and the stress result was S2AI group＞S, group＞S, + S2 group, of which the maximum stress value was 52.8 MPa in S1 group, 62.1 MPa in S2AI group, and 38.2 MPa in S1 + S2 group. The stress around the screws was also concentrated at the sacroiliac joint, and the stress result was S1 group＞S2AI group＞S1 + S2 group, of which the maximum stress value was 56.8 MPa in S1 group, 11.2 MPa in S2AI group, and 5.8 MPa in S1 + S2 group. Conclusions Single S1 screw, single S2 AI screw and S, screws combined S2 screws can be used for the treatment of unilateral C type sacroiliac joint dislocation. Early weight bearing of single S1 screw might lead to the risks of increased sacroiliac joint displacement and internal fixation failure. S2 AI screw fixation and S1 + S2 screw fixation have similar biomechanical strength, allowing early weight-bearing and contributing to better postoperative rehabilitation.