Does Posterior Fixation of Partially Unstable Open-Book Pelvic Ring Injuries Decrease Symphyseal Plate Failure? A...

Area of Science:

• Orthopedic surgery
• Biomechanics
• Trauma research

Background:

• Anteroposterior compression type-2 (APC-2) pelvic ring injuries are partially unstable.
• Clinical studies suggest potential benefits of iliosacral screws for APC-2 injuries.
• Biomechanical data on iliosacral fixation for APC-2 injuries are limited.

Purpose of the Study:

• To biomechanically evaluate the addition of an iliosacral screw to symphyseal plating for APC-2 pelvic injuries.
• To determine if supplemental iliosacral fixation reduces pelvic displacement in a cadaver model.

Main Methods:

• Human cadaveric pelves underwent simulated APC-2 injury creation.
• Specimens were treated with either symphyseal plating alone or plating plus an iliosacral screw.
• Pelvic displacement was measured under cyclic loading.

Main Results:

• No significant difference in pelvic displacement was observed between the two fixation groups.
• No implant failures occurred in the tested specimens.
• Post hoc analysis indicated a small effect size, requiring a large sample size to detect differences.

Conclusions:

• Supplemental iliosacral screw fixation does not enhance biomechanical stability in APC-2 pelvic injuries compared to symphyseal plating alone.
• Clinical stress examination may guide decisions for supplemental posterior fixation in APC-2 injuries.