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A biomechanical comparison of different fixation techniques for fractures of the acetabular posterior wall

International Orthopaedics volume 42, pages 673–679 (2018)Cite this article

A Correction to this article was published on 01 February 2019

This article has been updated

Abstract

Purpose

This study aimed to evaluate the biomechanical stability of different fixation techniques for fractures of the acetabular posterior wall. The hypothesis was that a reconstruction plate, combined with compression screw fixation and a plate placed lateral to the screws, would achieve a higher peak load to failure and stiffness and reduced gapping during cycle loading than other fixation techniques.

Methods

A total of 24 Sawbone pelvis models were created with simulated fractures at the posterior wall of the acetabulum. Anatomic reduction and internal fixation were performed randomly using one of four techniques: (A) reconstruction plate and compression screw fixation was placed with a plate medial to the screws; (B) plate and screw fixation with the plate located lateral to the screws; (C) plate fixation alone, and (D) screw fixation alone. Six models were tested in each group under cyclic and sustaining loading tests. Peak load to failure and stiffness were calculated from load displacement curves.

Results

Peak load to failure and stiffness in group B (3698.71 N and 2900.48 N/mm, respectively), featuring reconstruction plate and compression screw fixation with the plate placed lateral to the screws, were significantly higher than groups C (2508.74 N, 1602.75 N/mm) and D (2332.06 N, 1454.26 N/mm). No statistical differences were observed when group A (2941.60 N, 2136.50 N/mm) was compared with the other groups. There were no significant differences in gapping between groups.

Conclusions

Fixation using a reconstruction plate and compression screws placed lateral to the screws may address acetabular posterior wall fractures in a more appropriate manner than techniques using only plates or screws. However, this study does not provide evidence to support the fact that placing the plate lateral to the screws is advantageous in comparison with other techniques.

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Change history

  • 01 February 2019

    In the original publication, the following authors have been omitted due to a technical error in the original article:

  • 01 February 2019

    In the original publication, the following authors have been omitted due to a technical error in the original article:

  • 01 February 2019

    In the original publication, the following authors have been omitted due to a technical error in the original article:

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  1. Department of Orthopedics, Beijing Jishuitan Hospital, The Fourth Medical College, Peking University, Beijing, 100035, China

    Xinbao Wu

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  1. Xinbao Wu
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Correspondence to Xinbao Wu.

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Wu, X. A biomechanical comparison of different fixation techniques for fractures of the acetabular posterior wall. International Orthopaedics (SICOT) 42, 673–679 (2018). https://doi.org/10.1007/s00264-017-3728-3

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  • DOI: https://doi.org/10.1007/s00264-017-3728-3

Keywords

  • Acetabular posterior wall
  • Fracture
  • Biomechanical study
  • Fixation