Sacroiliac screw fixation for tile B fractures

Area of Science:

• Orthopedic Surgery
• Biomechanics
• Trauma Surgery

Background:

• Partially unstable pelvic fractures require effective stabilization.
• Tile B1 (open-book) fractures present specific challenges in maintaining pelvic ring integrity.

Purpose of the Study:

• To evaluate the biomechanical stability of combined symphysis plate fixation and posterior sacroiliac screw fixation for Tile B1 pelvic fractures.
• To compare this combined fixation technique against isolated anterior fixation and the intact state in a cadaveric model.

Main Methods:

• A Tile B1 pelvic fracture model was created in six cadaveric specimens.
• Three fixation conditions were tested: intact, isolated anterior plate fixation, and combined anterior plate with posterior sacroiliac screw fixation.
• Three-dimensional video analysis was used to measure translational and rotational stiffness, and load to failure.

Main Results:

• No significant differences in displacement or stiffness were observed between fixation techniques or compared to the intact state.
• Load to failure testing was limited, with fixation failure occurring in the pelvis-to-frame interface in most specimens.
• Applied loads in failure tests approximated full body weight, indicating substantial fixation strength but not differentiating techniques.

Conclusions:

• The addition of a posterior sacroiliac screw does not confer significant additional stability to anterior plate fixation in Tile B1 pelvic fractures.
• Further clinical investigation into direct postoperative weight-bearing is warranted to assess real-world implications.
• The study provides biomechanical data relevant to surgical decision-making in pelvic fracture management.