Posterior wall fracture is one of the most common fracture types of the acetabulum and a conventional approach is to perform open reduction and internal fixation with a plate and screws. Percutaneous screw fixations, on the other hand, have recently gained attention due to their benefits such as less exposure and minimization of blood loss. However their biomechanical stability, especially in terms interfragmentary movement, has not been investigated thoroughly. The aims of this study are twofold: (1) to measure the interfragmentary movements in the conventional open approach with plate fixations and the percutaneous screw fixations in the acetabular fractures and compare them; and (2) to develop and validate a fast and efficient way of predicting the interfragmentary movement in percutaneous fixation of posterior wall fractures of the acetabulum using a 3D finite element (FE) model of the pelvis. Our results indicate that in single fragment fractures of the posterior wall of the acetabulum, plate fixations give superior stability to screw fixations. However screw fixations also give reasonable stability as the average gap between fragment and the bone remained less than 1 mm when the maximum load was applied. Our finite element model predicted the stability of screw fixation with good accuracy. Moreover, when the screw positions were optimized, the stability predicted by our FE model was comparable to the stability obtained by plate fixations. Our study has shown that FE modeling can be useful in examining biomechanical stability of osteosynthesis and can potentially be used in surgical planning of osteosynthesis.
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e-mail: v.shim@auckland.ac.nz
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September 2011
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An Efficient and Accurate Prediction of the Stability of Percutaneous Fixation of Acetabular Fractures With Finite Element Simulation
V. B. Shim,
e-mail: v.shim@auckland.ac.nz
V. B. Shim
Auckland Bioengineering Institute, University of Auckland
, New Zealand
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J. Böshme,
J. Böshme
Department of Trauma,
Plastic and Reconstructive Surgery, University of Leipzig
, Germany
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P. Vaitl,
P. Vaitl
Department of Trauma,
Plastic and Reconstructive Surgery, University of Leipzig
, Germany
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C. Josten,
C. Josten
Department of Trauma,
Plastic and Reconstructive Surgery, University of Leipzig
, Germany
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I. A. Anderson
I. A. Anderson
Auckland Bioengineering Institute, University of Auckland
, New Zealand
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V. B. Shim
Auckland Bioengineering Institute, University of Auckland
, New Zealand
e-mail: v.shim@auckland.ac.nz
J. Böshme
Department of Trauma,
Plastic and Reconstructive Surgery, University of Leipzig
, Germany
P. Vaitl
Department of Trauma,
Plastic and Reconstructive Surgery, University of Leipzig
, Germany
C. Josten
Department of Trauma,
Plastic and Reconstructive Surgery, University of Leipzig
, Germany
I. A. Anderson
Auckland Bioengineering Institute, University of Auckland
, New Zealand
J Biomech Eng. Sep 2011, 133(9): 094501 (4 pages)
Published Online: October 4, 2011
Article history
Received:
April 18, 2011
Accepted:
June 23, 2011
Online:
October 4, 2011
Published:
October 4, 2011
Citation
Shim, V. B., Böshme , J., Vaitl , P., Josten, C., and Anderson, I. A. (October 4, 2011). "An Efficient and Accurate Prediction of the Stability of Percutaneous Fixation of Acetabular Fractures With Finite Element Simulation." ASME. J Biomech Eng. September 2011; 133(9): 094501. https://doi.org/10.1115/1.4004821
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