Posterior column acetabular fracture fixation using a W-shaped angular plate: A biomechanical analysis

Area of Science:

• Orthopedic surgery
• Biomechanical engineering
• Trauma research

Background:

• Acetabular fractures, particularly those involving the posterior column, present complex surgical challenges.
• Effective fixation is crucial for restoring joint stability and function.
• Existing fixation methods have varying degrees of biomechanical performance.

Purpose of the Study:

• To compare the stability and feasibility of four distinct fixation constructs for posterior column acetabular fractures.
• To evaluate the biomechanical performance of a novel W-shaped acetabular angular plate against traditional methods.

Main Methods:

• Twenty embalmed cadaveric pelvises with posterior column acetabular fractures were used.
• Four fixation groups were tested: single reconstruction plate, plate with lag screw, double reconstruction plates, and W-shaped acetabular angular plate.
• Mechanical loading and strain gauge analysis were performed to measure construct stiffness and strain distribution.

Main Results:

• The W-shaped acetabular angular plate and double reconstruction plates demonstrated superior stiffness compared to single plate or plate with lag screw constructs.
• The W-shaped plate fixation partially restored joint loading parameters, resembling the intact state.
• Strain distribution with the W-shaped plate was similar to the intact acetabulum, with lower parameters in the superior region.

Conclusions:

• The W-shaped acetabular angular plate provides the biomechanically stiffest construct for posterior column acetabular fracture stabilization.
• This novel fixation technique aids in restoring joint loading parameters, offering a promising alternative for acetabular fracture treatment.