Skip to main content
Log in

A biomechanical study of sacroiliac rod fixation for unstable pelvic ring injuries: verification of the “within ring” concept

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to compare the fixation power of sacroiliac rod fixation (SIRF), which was developed based on our original “within ring” concept to exclude the lumbar vertebra from the fixation range, and spinopelvic fixation (SPF) in a biomechanical experiment.

Methods

SPF and SIRF were applied to the posterior element in four bones each with the pelvic ring fracture model (AO/OTA classification 61-C1.3). A 300-N axial force was loaded on the fifth lumbar vertebra of the simulated pelvis. Then the stiffness (N/m) and deformation (mm) of SPF and SIRF were determined, and the final displacement (mm) of the fracture region and angular deformity (degrees) were measured. Displacements were measured using the markers at two sites of the sacral fracture [upper margin of the sacral ala (Ala) and second sacral vertebra level (S2)] and one site of the pubic symphysis (PS), and angular deformity was measured at Ala and PS.

Results

In SPF and SIRF, the mean stiffnesses and deformations showed no statistically significant difference. Only the vertical displacement at Ala differed significantly between SPF and SIRF (p = 0. 045), and the fixing force of SPF was higher. There was no other significant difference in vertical and horizontal displacement. The mean angular deformities also showed no significant difference between the two methods.

Conclusions

In biomechanics experiments, vertical resistance was stronger in SPF-treated than SIRF-treated bone, but stiffness and deformation, horizontal resistance, and angular deformity did not differ significantly.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Kach K, Trentz O (1994) Distraction spondylodesis of the sacrum in “vertical shear lesions” of the pelvis [in German]. Unfallchirurg 97:28–38

    CAS  PubMed  Google Scholar 

  2. Bellabarba C, Schildhauer TA, Vaccaro AR et al (2006) Complications associated with surgical stabilization of high-grade sacral fracture displacements with spino-pelvic instability. Spine 31:S80–S88

    Article  PubMed  Google Scholar 

  3. Schildhauer TA, Bellabarba C, Nork SE et al (2006) Decompression and lumbopelvic fixation for sacral fracture-displacements with spino-pelvic dissociation. J Orthop Trauma 20:447–457

    Article  PubMed  Google Scholar 

  4. Sagi HC, Militano U, Caron T et al (2009) A comprehensive analysis with minimum 1-year follow-up of vertically unstable transforaminal sacral fractures treated with triangular osteosynthesis. J Orthop Trauma 23:313–319

    Article  PubMed  Google Scholar 

  5. Bederman SS, Hassan JM, Shah KN, Kiester PD et al (2013) Fixation techniques for complex traumatic transverse sacral fractures: a systematic review. Spine 38:E1028–E1040

  6. Lindahl J, Mäkinen TJ, Koskinen SK et al (2014) Factors associated with outcome of spinopelvic dissociation treated with lumbopelvic fixation. Injury 45:1914–1920

    Article  PubMed  Google Scholar 

  7. Konig MA, Jehan S, Boszczyk AA et al (2012) Surgical management of U-shaped sacral fractures: a systematic review of current treatment strategies. Eur Spine J 21:829–836

    Article  CAS  PubMed  Google Scholar 

  8. Pearcy MJ, Portek I, Shepherd J (1984) Three dimensional X-ray analysis of normal movement in the lumbar spine. Spine 9:294–297

    Article  CAS  PubMed  Google Scholar 

  9. Keel MJB, Benneker LM, Siebenrock KA (2011) Less invasive lumbopelvic stabilization of posterior pelvic ring instability. J Trauma 71:E62–E70

    Article  PubMed  Google Scholar 

  10. Mouhsine E, Wettstein M, Schizas C et al (2006) Modified triangular posterior osteosynthesis of unstable sacrum fracture. Eur Spine J 15:857–863

    Article  CAS  PubMed  Google Scholar 

  11. Toogood P, McDonald E, Pekmezci M (2013) A biomechanical comparison of ipsilateral and contralateral pedicle screw placement for modified triangular osteosynthesis in unstable pelvic fractures. J Orthop Trauma 27:515–520

    Article  PubMed  Google Scholar 

  12. Karakaşlı A, Ceçen B, Erduran M, Taylan O, Hapa O, Havıtcıoğlu H (2014) Rigid fixation of the lumbar spine alters the motion and mechanical stability at the adjacent segment level. Eklem Hastalik Cerrahisi 25:42–46

    Article  PubMed  Google Scholar 

  13. Lawrence BD, Wang J, Arnold PM, Hermsmeyer J, Norvell DC, Brodke DS (2012) Predicting the risk of adjacent segment pathology after lumbar fusion: asystematic review. Spine 37:S123–S132

    Article  PubMed  Google Scholar 

  14. Park P, Garton HJ, Gala VC, Hoff JT, McGillicuddy JE (2004) Adjacent segment disease after lumbar or lumbosacral fusion: review of the literature. Spine 29:1938–1944

    Article  PubMed  Google Scholar 

  15. Verga E, Hearn T, Posell J et al (1995) Effects of methods of internal fixation of symphyseal disruptions on stability of pelvic ring. Injury 26:75–80

    Article  Google Scholar 

  16. Schildhauer TA, Ledoux WR, Chapman JR et al (2003) Triangular osteosynthesis and iliosacral screw fixation for unstable sacral fractures: a cadaveric and biomechanical evaluation under cyclic loads. J Orthop Trauma 17:22–31

    Article  PubMed  Google Scholar 

  17. Sagi HC (2009) Technical aspects and recommended treatment algorithms in triangular osteosynthesis and spinopelvic fixation for vertical shear transforaminal sacral fractures. J Orthop Trauma 23:354–360

    Article  PubMed  Google Scholar 

  18. Jazini E, Klocke N, Tannous O et al (2017) Does lumbopelvic fixation add stability? A cadaveric biomechanical analysis of an unstable pelvic fracture model. J Orthop Trauma 31:37–46

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tomonori Baba.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Futamura, K., Baba, T., Mogami, A. et al. A biomechanical study of sacroiliac rod fixation for unstable pelvic ring injuries: verification of the “within ring” concept. International Orthopaedics (SICOT) 42, 909–914 (2018). https://doi.org/10.1007/s00264-017-3713-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-017-3713-x

Keywords

Navigation