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Comparison of Modified Transiliac Internal Fixators: Mechanical Testing on Pelvic Models
M Salášek1, L Lobovský1, J Hluchá1
1NTIS - New Technologies for the Information Society, Faculty of Applied Sciences, University of West Bohemia, Plzeň, Czech Republic.
Acta Chirurgiae Orthopaedicae Et Traumatologiae Cechoslovaca
|November 5, 2021
Summary
Supraacetabular and dual transiliac internal fixators (TIFI-A and DTIFI) offer superior pelvic stability for vertical sacral fractures compared to the classical TIFI-C. These advanced TIFI methods provide significantly enhanced biomechanical support.
Area of Science:
- Orthopedic biomechanics
- Trauma surgery
- Pelvic fracture fixation
Background:
- Vertically unstable transforaminal sacral fractures pose significant clinical challenges.
- Existing transiliac internal fixator (TIFI) techniques include classical (TIFI-C), supraacetabular (TIFI-A), and dual (DTIFI) applications.
- Comparative biomechanical data on the efficacy of these TIFI variations for specific fracture patterns are limited.
Purpose of the Study:
- To biomechanically evaluate and compare the stiffness of different transiliac internal fixator (TIFI) techniques for stabilizing vertically unstable transforaminal sacral fractures.
- To assess the mechanical superiority of TIFI-A and DTIFI against TIFI-C in a simulated fracture model.
Main Methods:
- Mechanical loading tests were conducted on foam pelvic models (Sawbones 1301) to assess structural stiffness.
- A vertically unstable transforaminal sacral fracture was created and subsequently fixed using TIFI-C, TIFI-A, and DTIFI in separate models.
- Photogrammetry and load cells measured deformation and displacement to calculate stiffness ratios, with data analyzed using ANOVA and Tukey HSD tests.
Main Results:
- The mean stiffness ratios (treated/intact pelvis) were 0.638 ± 0.005 for TIFI-C, 0.722 ± 0.014 for TIFI-A, and 0.720 ± 0.008 for DTIFI.
- Both TIFI-A and DTIFI demonstrated significantly higher stiffness compared to TIFI-C (p < 0.0001).
- No significant difference in stiffness was found between TIFI-A and DTIFI (p = 0.9112).
Conclusions:
- For linear vertical transforaminal sacral fractures without comminution, TIFI-A and DTIFI provide superior biomechanical stability compared to TIFI-C.
- The supraacetabular and dual TIFI techniques offer comparable and enhanced fixation stiffness for these specific sacral fractures.
- These findings support the use of TIFI-A or DTIFI for improved outcomes in treating vertically unstable transforaminal sacral fractures.
