Top

Published in:

01-12-2011 | Original Paper

Biomechanical analysis of a transiliac internal fixator

Authors: Thomas Dienstknecht, Arne Berner, Andreas Lenich, Johannes Zellner, Michael Mueller, Michael Nerlich, Bernd Fuechtmeier

Published in: International Orthopaedics | Issue 12/2011

Abstract

Purpose

We evaluated the biomechanical characteristics of the transiliac internal fixator (TIFI) as compared to two well-established methods of internal posterior pelvic ring fixation.

Methods

Six freshly frozen human pelves were used for simulated single-leg stance loading of an AO type C injury model (pubic symphysis diastasis and unilateral sacroiliac joint disruption). The symphysis rupture was stabilized with a dynamic compression plate. Afterwards the three internal stabilization systems (TIFI, iliosacral screws and ventral plate osteosynthesis) were analysed. Fragment movement was measured in a contact-free manner with a stereophotometric infrared system.

Results

No significant differences in the three-dimensional deformation tolerated by the TIFI as compared to the other internal fixation systems were found.

Conclusions

The transiliac internal fixator provides the same biomechanical stability as the other reference implants tested. We suggest the use of this device as a suitable alternative to the other implants.

Tile M (1988) Pelvic ring fractures: should they be fixed? J Bone Joint Surg Br 70(1):1–12PubMed

Culemann U, Tosounidis G, Reilmann H, Pohlemann T (2004) Injury to the pelvic ring. Diagnosis and current possibilities for treatment. Unfallchirurg 107(12):1169–1181, quiz 1182–1163PubMedCrossRef

Pape HC, Giannoudis PV, Krettek C, Trentz O (2005) Timing of fixation of major fractures in blunt polytrauma: role of conventional indicators in clinical decision making. J Orthop Trauma 19(8):551–562PubMedCrossRef

Giannoudis PV, Pape HC (2004) Damage control orthopaedics in unstable pelvic ring injuries. Injury 35(7):671–677PubMedCrossRef

Nerlich M, Maghsudi M (1996) Algorithms for early management of pelvic fractures. Injury 27(Suppl 1):S-A29–S-A37

Pohlemann T, Tscherne H, Baumgartel F, Egbers HJ, Euler E, Maurer F, Fell M, Mayr E, Quirini WW, Schlickewei W, Weinberg A (1996) Pelvic fractures: epidemiology, therapy and long-term outcome. Overview of the multicenter study of the Pelvis Study Group. Unfallchirurg 99(3):160–167PubMed

Connor GS, McGwin G Jr, MacLennan PA, Alonso JE, Rue LW 3rd (2003) Early versus delayed fixation of pelvic ring fractures. Am Surg 69(12):1019–1023, discussion 1023–1014PubMed

Pohlemann T, Culemann U, Gansslen A, Tscherne H (1996) Severe pelvic injury with pelvic mass hemorrhage: determining severity of hemorrhage and clinical experience with emergency stabilization. Unfallchirurg 99(10):734–743PubMedCrossRef

Thannheimer A, Woltmann A, Vastmans J, Buhren V (2004) The unstable patient with pelvic fracture. Zentralbl Chir 129(1):37–42PubMedCrossRef

10.

Bottlang M, Simpson T, Sigg J, Krieg JC, Madey SM, Long WB (2002) Noninvasive reduction of open-book pelvic fractures by circumferential compression. J Orthop Trauma 16(6):367–373PubMedCrossRef

11.

Simpson LA, Waddell JP, Leighton RK, Kellam JF, Tile M (1987) Anterior approach and stabilization of the disrupted sacroiliac joint. J Trauma 27(12):1332–1339PubMedCrossRef

12.

Lehmann J (1934) Luxation einer Beckenhälfte. Zentralbl Chir 37:2149–2152

13.

Vanderschot P, Meuleman C, Lefevre A, Broos P (2001) Trans iliac-sacral-iliac bar stabilisation to treat bilateral lesions of the sacro-iliac joint or sacrum: anatomical considerations and clinical experience. Injury 32(7):587–592PubMedCrossRef

14.

Yinger K, Scalise J, Olson SA, Bay BK, Finkemeier CG (2003) Biomechanical comparison of posterior pelvic ring fixation. J Orthop Trauma 17(7):481–487PubMedCrossRef

15.

Kabak S, Halici M, Tuncel M, Avsarogullari L, Baktir A, Basturk M (2003) Functional outcome of open reduction and internal fixation for completely unstable pelvic ring fractures (type C): a report of 40 cases. J Orthop Trauma 17(8):555–562PubMedCrossRef

16.

Fuechtmeier B, Maghsudi M, Neumann C, Hente R, Roll C, Nerlich M (2004) The minimally invasive stabilization of the dorsal pelvic ring with the transiliacal internal fixator (TIFI)–surgical technique and first clinical findings. Unfallchirurg 107(12):1142–1151CrossRef

17.

van Zwienen CM, van den Bosch EW, Snijders CJ, Kleinrensink GJ, van Vugt AB (2004) Biomechanical comparison of sacroiliac screw techniques for unstable pelvic ring fractures. J Orthop Trauma 18(9):589–595PubMedCrossRef

18.

Saiki K, Hirabayashi S, Horie T, Tsuzuki N, Inokuchi K, Tsutsumi H (2002) Anatomically correct reduction and fixation of a Tile C-1 type unilateral sacroiliac disruption using a rod and pedicle screw system between the S1 vertebra and the ilium: experimental and clinical case report. J Orthop Sci 7(5):581–586PubMedCrossRef

19.

Mucha P Jr, Farnell MB (1984) Analysis of pelvic fracture management. J Trauma 24(5):379–386PubMedCrossRef

20.

Ragnarsson B, Olerud C, Olerud S (1993) Anterior square-plate fixation of sacroiliac disruption. 2–8 years follow-up of 23 consecutive cases. Acta Orthop Scand 64(2):138–142PubMedCrossRef

21.

Kellam JF, McMurtry RY, Paley D, Tile M (1987) The unstable pelvic fracture operative treatment. Orthop Clin North Am 18(1):25–41PubMed

22.

Giannoudis PV, Tzioupis CC, Pape HC, Roberts CS (2007) Percutaneous fixation of the pelvic ring: an update. J Bone Joint Surg Br 89(2):145–154PubMedCrossRef

23.

Hao T, Changwei Y, Qiulin Z (2009) Treatment of posterior pelvic ring injuries with minimally invasive percutaneous plate osteosynthesis. Int Orthop 33(5):1435–1439PubMedCrossRef

24.

Linde F, Sorensen HC (1993) The effect of different storage methods on the mechanical properties of trabecular bone. J Biomech 26(10):1249–1252PubMedCrossRef

25.

Panjabi MM, Krag M, Summers D, Videman T (1985) Biomechanical time-tolerance of fresh cadaveric human spine specimens. J Orthop Res 3(3):292–300PubMedCrossRef

26.

Shaw JA, Mino DE, Werner FW, Murray DG (1985) Posterior stabilization of pelvic fractures by use of threaded compression rods. Case reports and mechanical testing. Clin Orthop Relat Res 192:240–254PubMed

27.

Ponsen KJ, Hoek van Dijke GA, Joosse P, Snijders CJ (2003) External fixators for pelvic fractures: comparison of the stiffness of current systems. Acta Orthop Scand 74(2):165–171PubMedCrossRef

28.

Tornetta P 3rd, Matta JM (1996) Outcome of operatively treated unstable posterior pelvic ring disruptions. Clin Orthop Relat Res 329:186–193PubMedCrossRef

Title: Biomechanical analysis of a transiliac internal fixator
Authors: Thomas Dienstknecht
Arne Berner
Andreas Lenich
Johannes Zellner
Michael Mueller
Michael Nerlich
Bernd Fuechtmeier
Publication date: 01-12-2011
Publisher: Springer-Verlag
Published in: International Orthopaedics / Issue 12/2011
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-011-1251-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Biomechanical analysis of a transiliac internal fixator

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 12/2011

Mineralisation and mechanical strength of the glenoid cavity subchondral bone plate

Reply to the letter to the editor: Has the role of exchange nailing in femoral nonunion diminished?

Comments on Shuzhen Li et al. “Systematic review of patellar resurfacing in total knee arthroplasty”

Correlation of functional outcome and X-ray findings after Perthes disease

A systematic review of outcome and failure rate of uncemented Scandinavian total ankle replacement

Personalised modified osteotomy using computer-aided design–rapid prototyping to correct thoracic deformities