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首页> 外文期刊>Journal of Orthopaedic Translation >A novel percutaneous crossed screws fixation in treatment of Day type II crescent fracture–dislocation: A finite element analysis
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A novel percutaneous crossed screws fixation in treatment of Day type II crescent fracture–dislocation: A finite element analysis

机译：一种新型的经皮交叉螺钉固定术治疗II型Day新月型骨折脱位：有限元分析

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ObjectiveDay type II crescent fracture–dislocation is a subtype of pelvic lateral compression injury. At present, there is still a controversy on the operative approach and fixation technique. We have put forward closed reduction and percutaneous crossed screws fixation for treating type-II crescent fracture–dislocation. Finite element analysis is used to compare the biomechanical properties between percutaneous crossed screws and other internal fixations.MethodsA three-dimensional finite element model of Day type-II crescent fracture–dislocation was simulated using 5 implants, including double anterior plates (Model A), one posterior plate and one iliac screw (Model B), one sacroiliac joint screw (Model C), crossed one iliac screw and one sacroiliac joint screw (Model D), and crossed two iliac screws and one sacroiliac joint screw (Model E). 600-N stress was applied to S1 vertebral end-plate. To evaluate the biomechanical properties, the stress distribution and displacement distribution of the pelvis, stress distribution of the crescent fragment and stress distribution of plate and cannulated screw were recorded and analyzed.ResultsUnder the loading of 600N, the maximum pelvic displacements in the finite element model were compared as follows: model E (0.070??mm), model D (0.071??mm), model A (0.080??mm), model C (0.096??mm), and model B (0.112??mm). The maximum displacements of crescent fragment were compared as follows: model E (0.018??mm), model B (0.022??mm), model D (0.023??mm), model A (0.030??mm), and model C (0.043??mm). The maximum stress of all implants were compared as follows: model D (90.01??Mpa), model E (81.60??Mpa), model C (69.07??Mpa), model A (56.51??Mpa), model B (18.29??Mpa). Model E and model D could provide better mechanical support for whole pelvic.ConclusionsWith sufficient biomechanical stability and minimally invasive advantage, percutaneous crossed screw fixation is a recommended treatment for Day Type-II Crescent Fracture–dislocation. It is recommended to fix crescent fracture fragment and sacroiliac joint simultaneously during the operation. If it is difficult to fix the both position, the sacroiliac joint is preferentially fixed.The translational potential of this articleThere is a controversy on the operative approach and fixation technique of Day type-II crescent fracture–dislocation. This article proves that percutaneous crossed screw fixation is a recommended treatment for Day type-II crescent fracture–dislocation by finite element analysis.
机译：ObjectiveDay II型新月形骨折脱位是骨盆侧向压缩性损伤的一种。目前，关于手术方法和固定技术仍存在争议。我们提出了闭合复位和经皮交叉螺钉固定治疗II型新月形骨折脱位。方法使用5个植入物（包括双前板）（模型A）模拟Day II型新月形骨折脱位的三维有限元模型，方法是比较经皮交叉螺钉与其他内部固定之间的生物力学性能。 1个后板和1个骨螺钉（B型），1个sa关节螺钉（C型），交叉的1个ilia骨螺钉和1个sa关节螺钉（D型），以及交叉的2个ilia骨螺钉和1个cro关节螺钉（E型）。向S1椎骨终板施加600-N应力。为了评估其生物力学性能，记录并分析了骨盆的应力分布和位移分布，新月形碎片的应力分布以及板和空心螺钉的应力分布。结果在600N载荷下，有限元模型中的最大骨盆位移比较如下：模型E（0.070毫米），模型D（0.071毫米），模型A（0.080毫米），模型C（0.096毫米）和模型B（0.112毫米） 。比较新月形碎片的最大位移如下：E型（0.018mm），B型（0.022mm），D型（0.023mm），A型（0.030mm）和C型（0.043毫米）。比较所有植入物的最大应力如下：D型（90.01 ?? Mpa），E型（81.60 ?? Mpa），C型（69.07 ?? Mpa），A型（56.51 ?? Mpa），B型（ 18.29兆帕）。 E型和D型可以为整个骨盆提供更好的机械支持。结论具有足够的生物力学稳定性和微创优势，经皮交叉螺钉固定是II型新月形骨折脱位的推荐治疗方法。建议在手术中同时固定新月形骨折碎片和sa关节。如果难以固定两个位置，则优先固定sa关节。本文的翻译潜力在Day II型新月形骨折脱位的手术方法和固定技术上存在争议。本文通过有限元分析证明，经皮交叉螺钉固定是推荐的Day II型新月形骨折脱位的推荐治疗方法。

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