Biomechanical analysis of Magic screw fixation for acetabular posterior column fracture_Journal of Biomedical Engineering

Authors：

ZHANG Haowei ¹ , XU Zihuan ^1,2 , LIU Ying ¹ , WANG Yongqin ^1,2 , LI Pengfei ^1,2 , CAI Hongmin ³ ,  NI Ming ^2,4

1. School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, P. R. China;
2. Department of Orthopaedics, Shanghai Pudong New Area Peoples’ Hospital, Shanghai 201299, P. R. China;
3. Department of Pelvic and Acetabular Surgery, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Luoyang, Henan 471002, P. R. China;
4. Department of Science Development, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, P. R. China;

Corresponding author：

NI Ming, Email: gendianqing@163.com

Keywords：

Acetabular fracture; Finite element analysis; Internal fixation of fracture; Biomechanics

DOI：

10.7507/1001-5515.202109042

Video：

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This study aims to analyze the biomechanical stability of Magic screw in the treatment of acetabular posterior column fractures by finite element analysis. A three-dimensional finite element model of the pelvis was established based on the computed tomography (CT) and magnetic resonance imaging (MRI) data of a volunteer and its effectiveness was verified. Then, the posterior column fracture model of the acetabulum was generated. The biomechanical stability of the four internal fixation models was compared. The 500 N force was applied to the upper surface of the sacrum to simulate human gravity. The maximum implant stresses of retrograde screw fixation, single-plate fixation, double-plate fixation and Magic screw fixation model in standing and sitting position were as follows: 114.10, 113.40 MPa; 58.93, 55.72 MPa; 58.76, 47.47 MPa; and 24.36, 27.50 MPa, respectively. The maximum stresses at the fracture end were as follows: 72.71, 70.51 MPa; 48.18, 22.80 MPa; 52.38, 27.14 MPa; and 34.05, 30.78 MPa, respectively. The fracture end displacement of the retrograde tension screw fixation model was the largest in both states, and the Magic screw had the smallest displacement variation in the standing state, but it was significantly higher than the two plate fixations in the sitting state. Magic screw can satisfy the biomechanical stability of posterior column fracture. Compared with traditional fixations, Magic screw has the advantages of more uniform stress distribution and less stress, and should be recommended.

Citation： ZHANG Haowei, XU Zihuan, LIU Ying, WANG Yongqin, LI Pengfei, CAI Hongmin, NI Ming. Biomechanical analysis of Magic screw fixation for acetabular posterior column fracture. Journal of Biomedical Engineering, 2022, 39(4): 672-678. doi: 10.7507/1001-5515.202109042 Copy

1.	许玉林, 沈师, 卓乃强, 等. 髋臼后柱骨折3种不同钢板固定后站立及坐立位下的生物力学比较. 中国组织工程研究, 2021, 25(6): 826-830.
2.	Letournel E. Acetabulum fractures: classification and management. Clin Orthop Relat R, 2007, 5(151): 27-33.
3.	Giannoudis P V, Grotz M, Dinopoulos H. Operative treatment of displaced fractures of the acetabulum. A meta-analysis. J Bone Joint Surg (Br), 2005, 87(1): 2-9.
4.	刘潇, 李明, 刘建恒, 等. 不同手术入路治疗髋臼双柱骨折的研究进展. 中国修复重建外科杂志, 2021, 35(6): 661-666.
5.	黄杰鑫, 廖明新, 陈小杰. 新型H形解剖钛板治疗髋臼后壁/后柱骨折. 中国修复重建外科杂志, 2021, 35(1): 64-69.
6.	杨晓东, 夏广, 樊仕才, 等. 单一腹直肌外侧切口治疗髋臼前后柱骨折. 中华骨科杂志, 2015, 35(4): 335-340.
7.	Starr A J, Borer D S, Reinert C M. Technical aspects of limited open reduction and percutaneous screw fixation of fractures of the acetabulum. Oper Tech Orthop, 2001, 11(3): 218-226.
8.	Li J, Li Z, Wang X, et al. Establishment of fluoroscopy views and standardized procedure of percutaneous magic screw insertion for acetabulum fractures. BMC Musculoskelet Disord, 2018, 19(1): 332.
9.	陈剑飞, 高仕长, 余科权. 经皮Magic螺钉固定髋臼后柱骨折的影像解剖学. 解剖学报, 2020, 51(1): 85-92.
10.	Ruan Z, Luo C F, Zeng B F, et al. Percutaneous screw fixation for the acetabular fracture with quadrilateral plate involved by three-dimensional fluoroscopy navigation: Surgical technique. Injury, 2012, 43(4): 517-521.
11.	Phillips A, Pankaj P, Howie C R, et al. Finite element modelling of the pelvis: inclusion of muscular and ligamentous boundary conditions. Med Eng Phys, 2007, 29(7): 739-748.
12.	代元元. 髋臼骨折内固定方式的模拟生物力学及有限元分析. 广州: 广州中医药大学, 2016.
13.	Haddad Arabi Bulaqi, Mahmoud Mousavi Mashhadi, Hamed Safari, et al. Dynamic nature of abutment screw retightening: Finite element study of the effect of retightening on the settling effect. J Prosthet Dent, 2015, 113(5): 412-419.
14.	苏佳灿, 管华鹏, 张春才, 等. 静载荷作用下骨盆三维有限元分析及其生物力学意义. 中国组织工程研究, 2004, 20(7): 455-457.
15.	郭东鸿, 童凯, 王钢. 五种内固定方式固定髋臼后柱骨折生物力学特性的有限元分析. 中华创伤骨科杂志, 2020, 22(6): 529-535.
16.	樊艳平, 雷建银, 刘海波, 等. 站位骨盆有限元模型的建立. 太原理工大学学报, 2015, 46(1): 124-128.
17.	朱慧. 人工髋关节力学分析和优化设计. 柳州: 广西工学院, 2012.
18.	王满宜, 吴新宝, 荣国威. 髋臼骨折. 中国创伤骨科杂志, 2001(2): 10-15.
19.	王谦, 张堃. 髋臼骨折诊断、分型及治疗原则. 国际骨科学杂志, 2015, 36(1): 4-7.
20.	Frost H M. On our age-related bone loss: insights from a new paradigm. J Bone Miner Res, 1997, 12(10): 1539-1546.
21.	古金山, 杨朝晖, 栗树伟. 单一前路与前后联合入路治疗髋臼双柱骨折的力学分布差异. 中国组织工程研究, 2021, 25(33): 5254-5258.
22.	Pierannunzii L, Fischer F, Tagliabue L, et al. Acetabular both-column fractures: Essentials of operative management. Injury, 2010, 41(11): 1145-1149.
23.	Yang Yun, Zou Chang, Fang Yue. The Stoppa combined with iliac fossa approach for the treatment of both-column acetabular fractures. J Orthop Surg Res, 2020, 15(1): 588.
24.	董伊隆, 黄祥祥, 钱约男, 等. 不同台阶状移位对髋臼骨折的生物力学影响. 中国生物医学工程学报, 2017, 36(3): 370-374.

1. 许玉林, 沈师, 卓乃强, 等. 髋臼后柱骨折3种不同钢板固定后站立及坐立位下的生物力学比较. 中国组织工程研究, 2021, 25(6): 826-830.
2. Letournel E. Acetabulum fractures: classification and management. Clin Orthop Relat R, 2007, 5(151): 27-33.
3. Giannoudis P V, Grotz M, Dinopoulos H. Operative treatment of displaced fractures of the acetabulum. A meta-analysis. J Bone Joint Surg (Br), 2005, 87(1): 2-9.
4. 刘潇, 李明, 刘建恒, 等. 不同手术入路治疗髋臼双柱骨折的研究进展. 中国修复重建外科杂志, 2021, 35(6): 661-666.
5. 黄杰鑫, 廖明新, 陈小杰. 新型H形解剖钛板治疗髋臼后壁/后柱骨折. 中国修复重建外科杂志, 2021, 35(1): 64-69.
6. 杨晓东, 夏广, 樊仕才, 等. 单一腹直肌外侧切口治疗髋臼前后柱骨折. 中华骨科杂志, 2015, 35(4): 335-340.
7. Starr A J, Borer D S, Reinert C M. Technical aspects of limited open reduction and percutaneous screw fixation of fractures of the acetabulum. Oper Tech Orthop, 2001, 11(3): 218-226.
8. Li J, Li Z, Wang X, et al. Establishment of fluoroscopy views and standardized procedure of percutaneous magic screw insertion for acetabulum fractures. BMC Musculoskelet Disord, 2018, 19(1): 332.
9. 陈剑飞, 高仕长, 余科权. 经皮Magic螺钉固定髋臼后柱骨折的影像解剖学. 解剖学报, 2020, 51(1): 85-92.
10. Ruan Z, Luo C F, Zeng B F, et al. Percutaneous screw fixation for the acetabular fracture with quadrilateral plate involved by three-dimensional fluoroscopy navigation: Surgical technique. Injury, 2012, 43(4): 517-521.
11. Phillips A, Pankaj P, Howie C R, et al. Finite element modelling of the pelvis: inclusion of muscular and ligamentous boundary conditions. Med Eng Phys, 2007, 29(7): 739-748.
12. 代元元. 髋臼骨折内固定方式的模拟生物力学及有限元分析. 广州: 广州中医药大学, 2016.
13. Haddad Arabi Bulaqi, Mahmoud Mousavi Mashhadi, Hamed Safari, et al. Dynamic nature of abutment screw retightening: Finite element study of the effect of retightening on the settling effect. J Prosthet Dent, 2015, 113(5): 412-419.
14. 苏佳灿, 管华鹏, 张春才, 等. 静载荷作用下骨盆三维有限元分析及其生物力学意义. 中国组织工程研究, 2004, 20(7): 455-457.
15. 郭东鸿, 童凯, 王钢. 五种内固定方式固定髋臼后柱骨折生物力学特性的有限元分析. 中华创伤骨科杂志, 2020, 22(6): 529-535.
16. 樊艳平, 雷建银, 刘海波, 等. 站位骨盆有限元模型的建立. 太原理工大学学报, 2015, 46(1): 124-128.
17. 朱慧. 人工髋关节力学分析和优化设计. 柳州: 广西工学院, 2012.
18. 王满宜, 吴新宝, 荣国威. 髋臼骨折. 中国创伤骨科杂志, 2001(2): 10-15.
19. 王谦, 张堃. 髋臼骨折诊断、分型及治疗原则. 国际骨科学杂志, 2015, 36(1): 4-7.
20. Frost H M. On our age-related bone loss: insights from a new paradigm. J Bone Miner Res, 1997, 12(10): 1539-1546.
21. 古金山, 杨朝晖, 栗树伟. 单一前路与前后联合入路治疗髋臼双柱骨折的力学分布差异. 中国组织工程研究, 2021, 25(33): 5254-5258.
22. Pierannunzii L, Fischer F, Tagliabue L, et al. Acetabular both-column fractures: Essentials of operative management. Injury, 2010, 41(11): 1145-1149.
23. Yang Yun, Zou Chang, Fang Yue. The Stoppa combined with iliac fossa approach for the treatment of both-column acetabular fractures. J Orthop Surg Res, 2020, 15(1): 588.
24. 董伊隆, 黄祥祥, 钱约男, 等. 不同台阶状移位对髋臼骨折的生物力学影响. 中国生物医学工程学报, 2017, 36(3): 370-374.

Journal of Biomedical Engineering

Biomechanical analysis of Magic screw fixation for acetabular posterior column fracture

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