Berk, Till; Zderic, Ivan; Schwarzenberg, Peter; Pfeifer, Roman; Pastor, Tatjana; Halvachizadeh, Sascha; Richards, R Geoff; Gueorguiev, Boyko; Pape, Hans-Christoph (2023). Anterior column acetabulum fracture fixation with a screw-augmented acetabular cup-a biomechanical feasibility study. Clinical biomechanics, 109(106095), p. 106095. Elsevier 10.1016/j.clinbiomech.2023.106095
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BACKROUND
The beneficial effects of unrestricted postoperative full weight bearing for elderly patients suffering hip fractures have been demonstrated. However, there is still existing disagreement regarding acetabular fractures.The aim of this biomechanical study was to evaluate the initial load bearing capabilities of different fixation constructs of anterior column fractures (ACFs) in osteoporotic bone.
METHODS
Artificial pelvises with ACFs were assigned to three groups (n = 8) and fixed with either a 7.3 mm partially threaded antegrade cannulated screw (group AASS), an anteriorly placed 3.5 mm plate (group AAPF), or a press-fit acetabular cup with screw augmentation (group AACF). All specimens underwent ramped loading from 20 N preload to 200 N at a rate of 18 N/s, followed by progressively increasing cyclic testing at 2 Hz until failure performed at a rate of 0.05 N/cycle. Relative displacements of the bone fragments were monitored by motion tracking.
FINDINGS
Initial stiffness (N/mm) was 118.5 ± 34.3 in group AASS, 100.4 ± 57.5 in group AAPF, and 92.9 ± 44.0 in group AACF, with no significant differences between the groups, p = 0.544. Cycles to failure were significantly higher in groups AACF (8364 ± 2243) and AAPF (7827 ± 2881) compared to group AASS (4440 ± 2063), p ≤ 0.041.
INTERPRETATION
From a biomechanical perspective, the minimally invasive cup fixation with screw augmentation demonstrated comparable stability to plate osteosynthesis of ACFs in osteoporotic bone. The results of the present study do not allow to conclusively answer whether immediate full weight bearing following cup fixation shall be allowed. Given its similar performance to plate osteosynthesis, this remains rather an utopic wish and a more conservative approach deems more reasonable.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery > Hand Surgery 04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery |
UniBE Contributor: |
Pastor, Tatjana |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0268-0033 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
28 Sep 2023 14:26 |
Last Modified: |
01 Oct 2023 00:22 |
Publisher DOI: |
10.1016/j.clinbiomech.2023.106095 |
PubMed ID: |
37757678 |
Uncontrolled Keywords: |
Acetabulum fracture Anterior column fracture Biomechanics Feasibility Full weight bearing |
BORIS DOI: |
10.48350/186740 |
URI: |
https://boris.unibe.ch/id/eprint/186740 |
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