1.8.5 Internal fixation of lateral compression fractures (type B2)

2015 ◽  
Keyword(s):  
Internal Fixation ◽  
Lateral Compression ◽  
Compression Fractures

scholarly journals Tape suture for stabilization of incomplete posterior pelvic ring fractures—biomechanical analysis of a new minimally invasive treatment for incomplete lateral compression pelvic ring fractures

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Christopher Alexander Becker ◽  
Adrian Cavalcanti Kussmaul ◽  
Eduardo Manuel Suero ◽  
Markus Regauer ◽  
Matthias Woiczinski ◽  
...  
Keyword(s):  
Pelvic Ring ◽  
Tracking System ◽  
Fracture Site ◽  
Biomechanical Analysis ◽  
Lateral Compression ◽  
Posterior Pelvic Ring ◽  
Sacroiliac Screw ◽  
Minimal Invasiveness ◽  
Compression Fractures ◽  
Pelvic Ring Fractures

Abstract Background Incomplete lateral compression fractures (including AO Type B2.1) are among the most common pelvic ring injuries. Although the treatment of choice remains controversial, sacroiliac (SI) screws are commonly used for the operative treatment of incomplete lateral compression fractures of the pelvic ring. However, the disadvantages of SI screws include the risk of nerve root or blood vessel injury. Recently, tape sutures have been found useful as stabilizing material for the treatment of injuries of the syndesmosis, the rotator cuff and knee ligaments. In this current study, we aimed to test the biomechanical feasibility of tape sutures to stabilize the pelvis in the setting of AO Type B2.1 injury. Methods Six human cadaveric pelvises underwent cyclic loading to compare the biomechanical stability of different osteosynthesis methods in a B2.1 fracture model. The methods tested in this experiment were a FiberTape® suture and the currently established SI screw. A 3D ultrasound tracking system was used to measure fracture fragment motion. Linear regression was used to model displacement and stiffness at the posterior and anterior pelvic ring. Results At the posterior fracture site, the FiberTape® demonstrated similar displacement (2.2 ± 0.8 mm) and stiffness (52.2 ± 18.0 N/mm) compared to the sacroiliac screw (displacement 2.1 ± 0.6 mm, P >  0.999; stiffness 50.8 ± 13.0 N/mm, P > 0.999). Considering the anterior fracture site, the FiberTape® again demonstrated similar displacement (3.8 ± 1.3 mm) and stiffness (29.5 ± 9.0 N/mm) compared to the sacroiliac screw (displacement 2.9 ± 0.8 mm, P = 0.2196; stiffness 37.5 ± 11.5 N/mm, P = 0.0711). Conclusion The newly presented osteosynthesis, the FiberTape®, shows promising results for the stabilization of the posterior pelvic ring in AO Type B2.1 lateral compression fractures compared to a sacroiliac screw osteosynthesis based on its minimal-invasiveness and the statistically similar biomechanical properties.

Lateral compression fractures of the pelvis: The importance of plain radiographs in the diagnosis and surgical management

1986 ◽  
Vol 15 (2) ◽  
pp. 103-109 ◽  
Author(s):  
Jeremy W. R. Young ◽  
Andrew R. Burgess ◽  
Robert J. Brumback ◽  
Attila Poka
Keyword(s):  
Surgical Management ◽  
Lateral Compression ◽  
Plain Radiographs ◽  
Compression Fractures

scholarly journals Lateral compression fractures of the superior pubic ramus with intra-articular extension

2009 ◽  
Vol 91-B (9) ◽  
pp. 1208-1212 ◽  
Author(s):  
G. Y. Laflamme ◽  
J. Delisle ◽  
D. Rouleau ◽  
A.-P. Uzel ◽  
S. Leduc
Keyword(s):  
Lateral Compression ◽  
Pubic Ramus ◽  
Compression Fractures ◽  
Superior Pubic Ramus

scholarly journals Biomechanical finite element analysis of vertebral column resection and posterior unilateral vertebral resection and reconstruction osteotomy

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ye Han ◽  
Xiaodong Wang ◽  
Jincheng Wu ◽  
Hanpeng Xu ◽  
Zepei Zhang ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Vertebral Body ◽  
Vertebral Column ◽  
Vertebral Compression Fractures ◽  
Lateral Bending ◽  
Short Segment ◽  
Vertebral Column Resection ◽  
Compression Fractures ◽  
Short Segment Fixation ◽  
Vertebral Resection

Abstract Background Regarding the repair of vertebral compression fractures, there is a lack of adequate biomechanical verification as to whether only half of the vertebral body and the upper and lower intervertebral discs affect spinal biomechanics; there also remains debate as to the appropriate length of fixation. Methods A model of old vertebral compression fractures with kyphosis was established based on CT data. Vertebral column resection (VCR) and posterior unilateral vertebral resection and reconstruction (PUVCR) were performed at T12; long- and short-segment fixation methods were applied, and we analyzed biomechanical changes after surgery. Results Range of motion (ROM) decreased in all fixed models, with lumbar VCR decreasing the most and short posterior unilateral vertebral resection and reconstruction (SPUVCR) decreasing the least; in the long posterior unilateral vertebral resection and reconstruction (LPUVCR) model, the internal fixation system produced the maximum VMS stress of 213.25 mPa in a lateral bending motion and minimum stress of 40.22 mPa in a lateral bending motion in the SVCR. Conclusion There was little difference in thoracolumbar ROM between PUVCR and VCR models, while thoracolumbar ROM was smaller in long-segment fixation than in short-segment fixation. In all models, the VMS was most significant at the screw-rod junction and greatest at the ribcage–vertebral body interface, partly explaining the high probability of internal fixation failure and prosthesis migration in these two positions.

scholarly journals Outcome and 2-Year Survival Rate in Elderly Patients With Lateral Compression Fractures of the Pelvis

2016 ◽  
Vol 8 (1) ◽  
pp. 3-9 ◽  
Author(s):  
Andreas Höch ◽  
Orkun Özkurtul ◽  
Philipp Pieroh ◽  
Christoph Josten ◽  
Jörg Böhme
Keyword(s):  
Survival Rate ◽  
Elderly Patients ◽  
Lateral Compression ◽  
Compression Fractures

scholarly journals Treatment of Old Vertebral Compression Fracture With Kyphosis by Different Reconstruction Methods: a Finite Element Analysis

2020 ◽  
Author(s):  
Han Ye ◽  
Wang Xiaodong ◽  
Wu Jincheng ◽  
Xu Hanpeng ◽  
Zhang Zepei ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Vertebral Body ◽  
Compression Fracture ◽  
Vertebral Compression Fractures ◽  
Lateral Bending ◽  
Short Segment ◽  
Compression Fractures ◽  
Reconstruction Methods ◽  
Short Segment Fixation ◽  
Vertebral Resection

Abstract Background: In repair of vertebral compression fractures, there is a lack of effective biomechanical verification as to whether only half of the vertebral body and the upper and lower intervertebral discs has any effect on spinal biomechanics; there also remains debate as to the appropriate length of fixation.Methods: A model of old vertebral compression fractures with kyphosis was established based on CT data. Vertebral column resection (VCR) and posterior unilateral vertebral resection and reconstruction (PUVCR) were performed at T12; long- and short-segment fixation methods were applied, and we analyzed biomechanical changes after surgery.Results: Range of motion (ROM) decreased in all fixed models, with lumbar VCR decreasing the most and short posterior unilateral vertebral resection and reconstruction (SPUVCR) decreasing the least; in the long posterior unilateral vertebral resection and reconstruction (LPUVCR) model, the internal fixation system produced the maximum VMS stress of 213.25 MPa in a lateral bending motion, and a minimum stress of 40.22 MPa in a lateral bending motion in the SVCR.Conclusion: There was little difference in thoracolumbar ROM between PUVCR and VCR models, while thoracolumbar ROM was smaller in long-segment fixation than in short-segment fixation. In all models, the VMS was greatest at the screw-rod junction and greatest at the ribcage–vertebral body interface, which partly explains the high probability of internal fixation failure and prosthesis migration in these two positions.

scholarly journals Surgical options for symptomatic old osteoporotic vertebral compression fractures: A retrospective study of 238 cases

2020 ◽  
Author(s):  
Zhengwei Xu ◽  
Dingjun Hao ◽  
Liang Dong ◽  
Liang Yan ◽  
Baorong He
Keyword(s):  
Vertebral Fracture ◽  
Internal Fixation ◽  
Surgical Approaches ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Surgical Methods ◽  
The Difference ◽  
Sagittal Index

Abstract Background: Symptomatic osteoporotic vertebral compression fractures (OVCF) are increasing, as are acute and chronic pain episodes and progressive spinal deformities. However, there are no clear surgical treatment criteria for patients with these different symptoms. Therefore, this study aims to explore the surgical approaches for the treatment of OVCF with different symptoms and evaluate the feasibility of these surgical approaches.Methods: We retrospectively analyzed 238 symptomatic OVCF patients who entered our hospital from June 2013 to 2016. According to clinical characteristics and imaging examinations, these patients were divided into I-V grades and their corresponding surgical methods were developed. I, old vertebral fracture with no apparent instability, vertebral augmentation; II, old vertebral fracture with local instability, posterior reduction fusion internal fixation; III, old fractures with spinal stenosis, posterior decompression and reduction fusion and internal fixation; IV, old vertebral fracture with kyphosis, posterior osteotomy with internal fixation and fusion; V, a mixture of the above types, posterior osteotomy (decompression) with internal fixation and fusion. Postoperative visual analog score (VAS), oswestry disability index (ODI) scores, sagittal index (SI) and ASIA grades of neurological function were observed.Results: All 238 patients were followed up for 12-38 months, with an average follow-up of 18.5 months. After graded surgery, the VAS score, ODI score, and vertebral sagittal index SI of 238 patients were significantly improved, and the difference between the last follow-up results and the preoperative comparison was statistically significant (P˂0.05). Besides, the postoperative ASIA grades of 16 patients with nerve injury were improved from 14 patients with preoperative grade C, 2 patients with grade D to 4 patients with postoperative grade D and 12 patients with postoperative grade E.Conclusion: In this study, we concluded that graded surgery could better treat symptomatic old OVCF and restore spinal stability. This provides clinical reference and guidance for the treatment of symptomatic old OVCF in the future.

scholarly journals Surgical options for symptomatic old osteoporotic vertebral compression fractures: a retrospective study of 238 cases

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhengwei Xu ◽  
Dingjun Hao ◽  
Liang Dong ◽  
Liang Yan ◽  
Baorong He
Keyword(s):  
Vertebral Fracture ◽  
Internal Fixation ◽  
Surgical Approaches ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Surgical Methods ◽  
The Difference ◽  
Sagittal Index

Abstract Background Symptomatic osteoporotic vertebral compression fractures (OVCF) are increasing, as are acute and chronic pain episodes and progressive spinal deformities. However, there are no clear surgical treatment criteria for patients with these different symptoms. Therefore, this study aims to explore the surgical approaches for the treatment of OVCF with different symptoms and evaluate the feasibility of these surgical approaches. Methods We retrospectively analyzed 238 symptomatic OVCF patients who entered our hospital from June 2013 to 2016. According to clinical characteristics and imaging examinations, these patients were divided into I-V grades and their corresponding surgical methods were developed. I, old vertebral fracture with no apparent instability, vertebral augmentation; II, old vertebral fracture with local instability, posterior reduction fusion internal fixation; III, old fractures with spinal stenosis, posterior decompression and reduction fusion and internal fixation; IV, old vertebral fracture with kyphosis, posterior osteotomy with internal fixation and fusion; V, a mixture of the above types, posterior osteotomy (decompression) with internal fixation and fusion. Postoperative visual analog score (VAS), oswestry disability index (ODI) scores, sagittal index (SI) and ASIA grades of neurological function were observed. Results All 238 patients were followed up for 12–38 months, with an average follow-up of 18.5 months. After graded surgery, the VAS score, ODI score, and vertebral sagittal index SI of 238 patients were significantly improved, and the difference between the last follow-up results and the preoperative comparison was statistically significant (P ˂ 0.05). Besides, the postoperative ASIA grades of 16 patients with nerve injury were improved from 14 patients with preoperative grade C, 2 patients with grade D to 4 patients with postoperative grade D and 12 patients with postoperative grade E. Conclusion In this study, we concluded that graded surgery could better treat symptomatic old OVCF and restore spinal stability. This provides clinical reference and guidance for the treatment of symptomatic old OVCF in the future.

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