Related Experiment Video
Updated: Feb 5, 2026
Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
Published on: November 8, 2024
Minimally invasive screw fixation is as stable as anterior plating in acetabular T-Type fractures - a biomechanical
Christopher A Becker1, Christian Kammerlander1, Adrian Cavalcanti Kußmaul1
1Department of general trauma & reconstructive surgery, university hospital LMU Munich, Marchioninistr 15, 81377 Munich, Germany.
Introduction:
Operative treatments of T-type acetabular fractures are challenging surgical procedures. Open reduction and internal fixation is the standard method for the operative management of these fractures, however this is associated with high blood loss, long hospital stay and longer rehabilitation. Anterior subcutaneous pelvic fixation (internal fixation=INFIX) and retrograde pubic screw fixation have shown promising results in minimally invasive treatment of pelvic ring fractures. For T-type acetabular fractures, however, minimally invasive treatment concepts are still rare. Therefore we performed a mechanical in vitro study to: - investigate the potential favorability of minimally invasive treatment options over the already established open anterior locking plate osteosynthesis of acetabular T-fractures regarding biomechanical stability and post-surgical stiffness; - explore the biomechanical feasibility of the INFIX; - assess its potential ability to reduce the anterior acetabular column.
Hypothesis:
A minimally invasive treatment of acetabular T-type fractures is biomechanically equivalent to an open anterior plate osteosynthesis.
Methods:
Twenty-four synthetic hemipelvis specimens with a T-type acetabular fracture were divided in four groups. A posterior column screw was placed in every pelvis of every group. The anterior column was fixed with: - anterior column screw; - anterior column screw incl. INFIX; - INFIX alone; - 14-hole angular stable locking plate (standard fixation method). Displacement of the anterior column was reduced in group 2+3 using the INFIX. All specimens were cyclically loaded with 200N until a maximum of 600N. Movement/displacement of the fracture fragments were detected with a 3D-ultrasound measuring system. Displacement (mm) and Stiffness (N/mm) of the construction were analyzed.
Results:
Statistical assessment showed no significant differences between the four fixation types (p>0.05). The 14-whole locking plate (group 4) displayed the overall highest stability with a displacement of 1.3±0.04mm and stiffness of 76.3±2.4N/mm. Anterior screw fixation (group 1) proved to be the minimally invasive fixation method with the least displacement and highest stiffness (1.5±0.2mm, 68.3±6.8N/mm). The combination of an INFIX and an anterior column screw (group 2), showed a mean stiffness of 62.1±6.0N/mm and a mean displacement of 1.7±0.2mm. INFIX only (group 3) presented a displacement of 1.6±0.1mm and a stiffness of 64.5±4.5N/mm.
Discussion:
Minimally invasive fixation techniques for T-type acetabular fractures show promising biomechanical stability in non- or slightly displaced fractures. Furthermore, INFIX could be a feasible tool for the reduction of the anterior acetabular column.
Level Of Evidence:
III, case control prospective experimental study.
More Related Videos
06:41A Minimally Invasive Model to Analyze Endochondral Fracture Healing in Mice Under Standardized Biomechanical Conditions
Published on: March 22, 2018
15:11Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling
Published on: January 5, 2015
Related Concept Videos
01:12Types of Errors: Detection and Minimization
Absolute error in a measurement is the numerical difference from the true or central value. Relative error is the ratio between absolute error and the true or central value, expressed as a percentage.
Errors can be classified by source, magnitude, and sign. There are three types of errors: systematic, random, and gross.
Systematic or...
01:21Screw: Problem Solving
To evaluate the...
01:16Self-Locking Screw
A square-threaded screw jack carrying a load is considered self-locking if the screw retains its position even after the moment applied to it is removed.
01:17Frictional Forces on Screws
A jack with a square-threaded screw is a mechanical device used to lift heavy loads by applying a force at its handle. When the force is applied, the screw turns, raising the load. The screw can...
01:03Fixation and Sectioning
The simplest type of preparation is the wet mount, in which the specimen is placed in a drop of liquid on the slide. A liquid specimen can be directly deposited on the slide using a dropper. Solid specimens, such as skin scraping, can be placed on the slide before adding a drop of liquid to prepare the wet mount. Sometimes the liquid is simply water, but stains are often added...
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...