Biomechanical stability of sacroiliac screw osteosynthesis with and without cement augmentation.
Cement-augmentation
Fragility fractures of the pelvis
Pelvic ring injuries
Pelvis screw osteosynthesis biomechanics
Percutaneous sacroiliac screws
Journal
Injury
ISSN: 1879-0267
Titre abrégé: Injury
Pays: Netherlands
ID NLM: 0226040
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
received:
21
11
2019
revised:
26
01
2020
accepted:
28
01
2020
pubmed:
9
2
2020
medline:
3
11
2021
entrez:
9
2
2020
Statut:
ppublish
Résumé
Percutaneous sacroiliac (SI) screw fixation is the standard operative treatment of traumatic disruptions to the posterior pelvic ring. The technique offers good outcomes and early postoperative mobilization, which is vital in elderly patients with fragility fractures of the pelvis. While a double-screw technique has been shown to provide optimal biomechanical stability compared to a single-screw construct, anatomic variations and patient-specific characteristics may prevent the safe insertion of two SI screws. We aimed to determine whether cement augmentation of a single SI screw would provide biomechanical stability comparable to that of the double-screw technique. Three sacroiliac screw osteosynthesis configurations were tested on 10 human cadaveric pelvis specimens: a single cannulated screw; two cannulated screws; and a single, cement-augmented cannulated screw. Displacement and stiffness of the anterior and posterior pelvic ring after fixation with each technique were measured under axial load. Results where compared using linear regression and paired t-tests. A single uncemented screw offered significantly worse stability in the anterior pelvis compared to a double-screw technique (P < 0.05) and to a single cement-augmented screw technique (P < 0.05). There was no significant difference in anterior pelvic ring stability between the single cement-augmented screw technique and the double-screw technique (P > 0.05). There was no significant difference in the stability of the posterior pelvic ring between the three techniques (P > 0.05). A single cement-augmented cannulated sacroiliac screw provides biomechanical stability similar to that of a non-augmented double-screw technique in the treatment of posterior pelvic ring fractures.
Sections du résumé
BACKGROUND
BACKGROUND
Percutaneous sacroiliac (SI) screw fixation is the standard operative treatment of traumatic disruptions to the posterior pelvic ring. The technique offers good outcomes and early postoperative mobilization, which is vital in elderly patients with fragility fractures of the pelvis. While a double-screw technique has been shown to provide optimal biomechanical stability compared to a single-screw construct, anatomic variations and patient-specific characteristics may prevent the safe insertion of two SI screws. We aimed to determine whether cement augmentation of a single SI screw would provide biomechanical stability comparable to that of the double-screw technique.
METHODS
METHODS
Three sacroiliac screw osteosynthesis configurations were tested on 10 human cadaveric pelvis specimens: a single cannulated screw; two cannulated screws; and a single, cement-augmented cannulated screw. Displacement and stiffness of the anterior and posterior pelvic ring after fixation with each technique were measured under axial load. Results where compared using linear regression and paired t-tests.
RESULTS
RESULTS
A single uncemented screw offered significantly worse stability in the anterior pelvis compared to a double-screw technique (P < 0.05) and to a single cement-augmented screw technique (P < 0.05). There was no significant difference in anterior pelvic ring stability between the single cement-augmented screw technique and the double-screw technique (P > 0.05). There was no significant difference in the stability of the posterior pelvic ring between the three techniques (P > 0.05).
CONCLUSIONS
CONCLUSIONS
A single cement-augmented cannulated sacroiliac screw provides biomechanical stability similar to that of a non-augmented double-screw technique in the treatment of posterior pelvic ring fractures.
Identifiants
pubmed: 32033807
pii: S0020-1383(20)30071-1
doi: 10.1016/j.injury.2020.01.043
pii:
doi:
Substances chimiques
Bone Cements
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2707-2711Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest None of the authors have any conflicts of interest related to this work.