Contact characteristics research of acetabular weight-bearing area with different internal fixation methods after compression fracture of acetabular dome_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

XU Bowen ^1,2 , ZHANG Qingsong ² , AN Siqi ¹ , PEI Baorui ¹ ,  WU Xiaobo ³

1. School of Graduate, North China University of Science and Technology, Tangshan Hebei, 063000, P.R.China;
2. Department of General Surgery, Kailuan General Hospital, Tangshan Hebei, 063000, P.R.China;
3. Department of Orthopaedics, the Third Affiliated Hospital of Hebei Medical University, Shijiazhuang Hebei, 050051, P.R.China;

Corresponding author：

WU Xiaobo, Email: drwuxiaobo@foxmail.com

Keywords：

Acetabular dome; compression fracture; internal fixation; contact characteristics

DOI：

10.7507/1002-1892.201704038

Video：

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ObjectiveTo establish the model of compression fracture of acetabular dome, and to measure the contact characteristics of acetabular weight-bearing area of acetabulum after 3 kinds of internal fixation.MethodsSixteen fresh adult half pelvis specimens were randomly divided into 4 groups, 4 specimens each group. Group D was the complete acetabulum (control group), and the remaining 3 groups were prepared acetabular dome compression fracture model. The fractures were fixed with reconstruction plate in group A, antegrade raft screws in group B, and retrograde raft screws in group C. The pressure sensitive films were attached to the femoral head, and the axial compression test was carried out on the inverted single leg standing position. The weight-bearing area, average stress, and peak stress were measured in each group.ResultsUnder the loading of 500 N, the acetabular weight-bearing area was significantly higher in group D than in other 3 groups (P<0.05), and the average stress and peak stress were significantly lower than in other 3 groups (P<0.05). The acetabular weight-bearing area were significantly higher in group B and group C than in group A, and the average stress and peak stress were significantly lower than in group A (P<0.05). There was no significant difference in the above indexes between group B and group C (P>0.05).ConclusionFor the compression fracture of the acetabular dome, the contact characteristics of the weight-bearing area can not restore to the normal level, even if the anatomical reduction and rigid internal fixation were performed; compared with the reconstruction plate fixation, antegrade and retrograde raft screws fixations can increase the weight-bearing area, reduce the average stress and peak stress, and reduce the incidence of traumatic arthritis.

Citation： XU Bowen, ZHANG Qingsong, AN Siqi, PEI Baorui, WU Xiaobo. Contact characteristics research of acetabular weight-bearing area with different internal fixation methods after compression fracture of acetabular dome. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(8): 902-907. doi: 10.7507/1002-1892.201704038 Copy

1.	Berkebile RD, Fischer DL, Albrecht LF. Thegull-wingsign. Value of the lateral view of the pelvis in fracture-dislocation of the acetabular rim and posterior dislocation of the femoral head. Radiology, 1965, 84(2): 937-939.
2.	Anglen JO, Burd TA, Hendricks KJ, et al. The " Gull Sign”: a harbinger of failure for internal fixation of geriatric acetabular fractures. J OrthopTrauma, 2003, 17(9): 625-634.
3.	Letournel E. Acetabulum fractures: classification and management. Clin Orthop Relat Res, 1980, (151): 81-106.
4.	Matta JM. Operative treatment of acetabular fractures through the ilioinguinal approach: a 10-year perspective. J OrthopTrauma, 2006, 20(1 Suppl): S20-29.
5.	毛宾尧. 人工髋关节外科学. 北京: 人民卫生出版社, 2010: 121.
6.	Zhuang Y, Lei JL, Wei X, et al. Surgical treatment of acetabulum top compression fracture with sea gull sign. Orthop Surg, 2015, 7(2): 146-154.
7.	Knight RA, Smith H. Central fractures of the acetabulum. J BoneJoint Surg (Am), 1958, 40-A(1): 1-16.
8.	Olson SA, Schemitsch G, Morwood M, et al. Hot Topics in Biomechanics: Hip Fracture Fixation. J OrthopTrauma, 2015, 29 Suppl 12: S1-5.
9.	陈国富, 朱忠, 梁军波, 等. 开窗法复位植骨内固定治疗髋臼前柱骨折合并臼顶区关节面压缩塌陷的临床研究. 中国骨伤, 2011, 24(2): 112-115.
10.	Laflamme GY, Hebert-Davies J. Direct reduction technique for superomedial dome impaction in geriatric acetabular fractures. J Orthop Trauma, 2013, 28(2): e39-43.
11.	Day WH, Swanson SA, Freeman MA. Contact pressures in the loaded human cadaver hip. J BoneJoint Surg, 1975, 57(3): 302-313.
12.	Olson SA, Marsh JL, Anderson DD, et al. Designing a biomechanics investigation: choosing the right model. J Orthop Trauma, 2012, 26(12): 672-677.
13.	Li YL, Tang YY. Displaced acetabular fractures in the elderly: Results after open reduction and internal fixation. Injury, 2014, 45(12): 1908-1913.
14.	Tosounidis TH, Gudipati S, Panteli M, et al. The use of buttress plates in the management of acetabular fractures with quadrilateral plate involvement: is it still a valid option? Int Orthop, 2015, 39(11): 2219-2226.
15.	Butterwick D, Papp S, Gofton W, et al. Acetabular fractures in the elderly: evaluation and management. J Bone Joint Surg (Am), 2015, 97(9): 758-768.
16.	de Paiva Luciano A, Filho NF. Stress fracture in acetabular roof due to motocross: case report. Rev Bras Ortop, 2016, 51(3): 374-377.
17.	张继宗. 法医人类学. 北京: 人民卫生出版社, 2009: 380-388.
18.	Domazet N, Starović D, Nedeljković R. Biomechanical significance of the acetabular roof and its reaction to mechanical injury. Srp Arh Celok Lek, 1999, 127(11-12): 359-364.
19.	Olson SA, Furman BD, Kraus VB, et al. Therapeutic opportunities to prevent post‐traumatic arthritis: Lessons from the natural history of arthritis after articular fracture. J Orthop Res, 2015, 33(9): 1266-1277.
20.	Yildirim AO, Alemdaroglu KB, Yuksel HY, et al. Finite element analysis of the stability of transverse acetabular fractures in standing and sitting positions by different fixation options. Injury, 2015, 46(1): S29-35.

1. Berkebile RD, Fischer DL, Albrecht LF. Thegull-wingsign. Value of the lateral view of the pelvis in fracture-dislocation of the acetabular rim and posterior dislocation of the femoral head. Radiology, 1965, 84(2): 937-939.
2. Anglen JO, Burd TA, Hendricks KJ, et al. The " Gull Sign”: a harbinger of failure for internal fixation of geriatric acetabular fractures. J OrthopTrauma, 2003, 17(9): 625-634.
3. Letournel E. Acetabulum fractures: classification and management. Clin Orthop Relat Res, 1980, (151): 81-106.
4. Matta JM. Operative treatment of acetabular fractures through the ilioinguinal approach: a 10-year perspective. J OrthopTrauma, 2006, 20(1 Suppl): S20-29.
5. 毛宾尧. 人工髋关节外科学. 北京: 人民卫生出版社, 2010: 121.
6. Zhuang Y, Lei JL, Wei X, et al. Surgical treatment of acetabulum top compression fracture with sea gull sign. Orthop Surg, 2015, 7(2): 146-154.
7. Knight RA, Smith H. Central fractures of the acetabulum. J BoneJoint Surg (Am), 1958, 40-A(1): 1-16.
8. Olson SA, Schemitsch G, Morwood M, et al. Hot Topics in Biomechanics: Hip Fracture Fixation. J OrthopTrauma, 2015, 29 Suppl 12: S1-5.
9. 陈国富, 朱忠, 梁军波, 等. 开窗法复位植骨内固定治疗髋臼前柱骨折合并臼顶区关节面压缩塌陷的临床研究. 中国骨伤, 2011, 24(2): 112-115.
10. Laflamme GY, Hebert-Davies J. Direct reduction technique for superomedial dome impaction in geriatric acetabular fractures. J Orthop Trauma, 2013, 28(2): e39-43.
11. Day WH, Swanson SA, Freeman MA. Contact pressures in the loaded human cadaver hip. J BoneJoint Surg, 1975, 57(3): 302-313.
12. Olson SA, Marsh JL, Anderson DD, et al. Designing a biomechanics investigation: choosing the right model. J Orthop Trauma, 2012, 26(12): 672-677.
13. Li YL, Tang YY. Displaced acetabular fractures in the elderly: Results after open reduction and internal fixation. Injury, 2014, 45(12): 1908-1913.
14. Tosounidis TH, Gudipati S, Panteli M, et al. The use of buttress plates in the management of acetabular fractures with quadrilateral plate involvement: is it still a valid option? Int Orthop, 2015, 39(11): 2219-2226.
15. Butterwick D, Papp S, Gofton W, et al. Acetabular fractures in the elderly: evaluation and management. J Bone Joint Surg (Am), 2015, 97(9): 758-768.
16. de Paiva Luciano A, Filho NF. Stress fracture in acetabular roof due to motocross: case report. Rev Bras Ortop, 2016, 51(3): 374-377.
17. 张继宗. 法医人类学. 北京: 人民卫生出版社, 2009: 380-388.
18. Domazet N, Starović D, Nedeljković R. Biomechanical significance of the acetabular roof and its reaction to mechanical injury. Srp Arh Celok Lek, 1999, 127(11-12): 359-364.
19. Olson SA, Furman BD, Kraus VB, et al. Therapeutic opportunities to prevent post‐traumatic arthritis: Lessons from the natural history of arthritis after articular fracture. J Orthop Res, 2015, 33(9): 1266-1277.
20. Yildirim AO, Alemdaroglu KB, Yuksel HY, et al. Finite element analysis of the stability of transverse acetabular fractures in standing and sitting positions by different fixation options. Injury, 2015, 46(1): S29-35.

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Contact characteristics research of acetabular weight-bearing area with different internal fixation methods after compression fracture of acetabular dome

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