Can Screw-only fixations of ACPHT acetabular fractures enhance stability as the standard buttress plate fixation provides?

Open Access

Year : 2024 | Volume :13 | Issue : 01 | Page : 64-73
By

Chol-Song Kang

Ran-Hwi Kang

Chon Pak

Tae-Pom Choe

Kwang-Hyok Pak

Sung-Chol Ri

Abstract

Background: Of acetabular fractures, anterior column posterior hemi-transverse(ACPHT) fractures commonly occur after a fall onto the hip in elderly population. When displaced in these fractures, open reduction and internal fixation using plate and screws is usually required to achieve good functional outcomes. The open procedures, however, involve high complication rates due to surgical invasion; therefore, percutaneous techniques by screw-only constructs have been advocated to minimize these complications. The purpose of this study was to compare biomechanical stability of lag screw fixations with a reconstruction plate 3.5 by finite element methods. Methods: Based on the CT scans of left hemipelves and femur and reconstruction plate 3.5 or 6.5mm, 32mm-partially-threaded cannulated screws, 3D-finite element models of left acetabular fractures, Judet & Letournel classification ACPHT fixed with the reconstruction plate 3.5 or the lag screws were built to compare their biomechanical characteristics with ANSYS WORKBENCH programme when applied 3 types of loads including axial compressions in extension, 90°flexion and 30° external rotation of hip respectively. Results: There were no significant differences in displacements and stiffness at fracture sites between the plate fixation and screw-only fixations under axial compression loads in extension and 90° flexion of hip, but the former produced 1.54mm and 0.29MPa less than 2.13mm and 0.63MPa of screw-only fixations under axial compression in 30° external rotation of hip. Conclusion: Screw-only fixations of the ACPHT acetabular fractures provide stability similar to buttress plate fixation under axial compression loads in extension and flexion of hip.

Keywords: pelvis, acetabular, screw, plate, biomechanics

[This article belongs to Research & Reviews : Journal of Surgery(rrjos)]

How to cite this article: Chol-Song Kang, Ran-Hwi Kang, Chon Pak, Tae-Pom Choe, Kwang-Hyok Pak, Sung-Chol Ri. Can Screw-only fixations of ACPHT acetabular fractures enhance stability as the standard buttress plate fixation provides?. Research & Reviews : Journal of Surgery. 2024; 13(01):64-73.
How to cite this URL: Chol-Song Kang, Ran-Hwi Kang, Chon Pak, Tae-Pom Choe, Kwang-Hyok Pak, Sung-Chol Ri. Can Screw-only fixations of ACPHT acetabular fractures enhance stability as the standard buttress plate fixation provides?. Research & Reviews : Journal of Surgery. 2024; 13(01):64-73. Available from: https://journals.stmjournals.com/rrjos/article=2024/view=150292

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Regular Issue Open Access Original Research
Volume 13
Issue 01
Received March 22, 2024
Accepted March 25, 2024
Published April 12, 2024
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