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Biomechanical study of posterior wall acetabular fracture fixation using acetabular tridimensional memory
Liu Xin-wei1, Xu Shuo-gui, Zhang Chun-cai
1Department of Orthopaedic Surgery, Changhai Hospital, The Second Military Medical University, No. 168 Changhai Road, Shanghai 200433, China.
Background:
We developed the acetabular tridimensional memory alloy-fixation system (ATMFS), which is made of NiTi shape memory alloy, according to the specific mechanical properties of biological memory material, nitinol alloy and measured distribution of contact area and pressure between the acetabulum and the femoral head of cadaveric pelvis.
Methods:
Six formalin-preserved cadaveric pelvis were used for this investigation. Pressure-sensitive film was used to measure contact area and pressure within the anterior, superior, and posterior regions of the acetabulum. The pelvis were loaded under the following four conditions: (1) intact; (2) following a creation posterior wall fracture defect; (3) following reduction and standard internal fixation with reconstruction plate; (4) following reduction and internal fixation with a new shape memory alloy device named ATMFS. A posterior wall fracture was created along an arc of 40-90 degrees about the acetabular rim.
Findings:
Creation of a posterior wall defect resulted in increased load in the superior acetabulum (1422N) as compared to the intact condition (762N, P=0.007). Following reduction and internal fixation, the load distributed to the superior acetabulum (1486N) was not statistically different from the defect condition. Following the fixation with ATMFS, the load seen at the superior region of the actabulum (936N) was less than fixation with reconstruction plate and was not different from intact state (P=0.4).
Interpretation:
These data indicate that the use of ATMFS as a fracture internal fixation device resulted a partial restoration of joint loading parameters toward the intact state. ATMFS fixation may result in a clinical benefit.
