Abstract
[Objective] To compare the mechanical characteristics of percutaneous long plate, percutaneous pubic superioris intramedullary screw and percutaneous pelvic anterior screw-rod system for the treatment of bilateral vertical pubic fractures to provide reference for clinical application. [Methods] A finite element model of pelvic anterior ring injury (bilateral vertical pubic fracture) was produced. The fractures were fixed with percutaneous long plate, percutaneous pubic superioris intramedullary screw, percutaneous pelvic anterior screw-rod system and their combination in 5 types of models. The fracture stability under vertical, bilateral and anterior-posterior load were quantified and compared based on the displacement of the hip joints’ midpoint as quantificational index of fracture stability. [Results] In condition of bilateral and anterior-posterior load, the vertical, bilateral and anterior-posterior displacement of the hip joints’ midpoint of different models were significantly different respectively. In general, the displacement of the 5 pelvic anterior ring fixation models were ranked from maximum to minimum as follows: long plate, pelvic anterior screw-rod system, combination of long plate and pelvic anterior screw-rod system, pubic superioris intramedullary screw and combination of pubic superioris intramedullary screw and pelvic anterior screw-rod system. [Conclusion] For the fixation in bilateral pubic fractures of pelvic injury, the percutaneous pubic superioris intramedullary screw was optimal, percutaneous pelvic anterior screw-rod system was the second choice, and percutaneous long plate ranked the third. The percutaneous pelvic anterior screw-rod system can significantly increase fixation stability of the percutaneous pubic superioris intramedullary screw and the percutaneous long plate.
Penetrating deep pelvic injury due to “less-lethal” beanbag munitions: a case report and policy implications
