Evidence map›Paper›PMID 38671770›Full record

ArticleBioengineering (Basel, Switzerland)2024

Pelvic Ring Fractures: A Biomechanical Comparison of Sacral and Lumbopelvic Fixation Techniques.

Sudharshan Tripathi, Norihiro Nishida, Sophia Soehnlen, Amey Kelkar, Yogesh Kumaran, Toshihiro Seki, Takashi Sakai, Vijay K Goel

Open access · goldAbstract read
In one paragraph

Article in Bioengineering (Basel, Switzerland), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.1field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 2 countries.

Sudharshan TripathiEngineering Center for Orthopedic Research (E-CORE), Department of Bioengineering and Orthopaedic Surgery, University of Toledo, Toledo, OH 43606, USA.
Norihiro NishidaDepartment of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube 755-8505, Yamaguchi, Yamaguchi Prefecture, Japan.ORCID 0000-0001-7754-6579
Sophia SoehnlenEngineering Center for Orthopedic Research (E-CORE), Department of Bioengineering and Orthopaedic Surgery, University of Toledo, Toledo, OH 43606, USA.
Amey KelkarEngineering Center for Orthopedic Research (E-CORE), Department of Bioengineering and Orthopaedic Surgery, University of Toledo, Toledo, OH 43606, USA.
Yogesh KumaranEngineering Center for Orthopedic Research (E-CORE), Department of Bioengineering and Orthopaedic Surgery, University of Toledo, Toledo, OH 43606, USA.ORCID 0000-0002-3437-3337
Toshihiro SekiDepartment of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube 755-8505, Yamaguchi, Yamaguchi Prefecture, Japan.
Takashi SakaiDepartment of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube 755-8505, Yamaguchi, Yamaguchi Prefecture, Japan.
Vijay K GoelEngineering Center for Orthopedic Research (E-CORE), Department of Bioengineering and Orthopaedic Surgery, University of Toledo, Toledo, OH 43606, USA.
University of Toledo · USYamaguchi University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background contextPelvic ring fractures are becoming more common in the aging population and can prove to be fatal, having mortality rates between 10% and 16%. Stabilization of these fractures is challenging and often require immediate internal fixation. Therefore, it is necessary to have a biomechanical understanding of the different fixation techniques for pelvic ring fractures.

methodsA previously validated three-dimensional finite element model of the lumbar spine, pelvis, and femur was used for this study. A unilateral pelvic ring fracture was simulated by resecting the left side of the sacrum and pelvis. Five different fixation techniques were used to stabilize the fracture. A compressive follower load and pure moment was applied to compare different biomechanical parameters including range of motion (contralateral sacroiliac joint, L1-S1 segment, L5-S1 segment), and stresses (L5-S1 nucleus stresses, instrument stresses) between different fixation techniques.

resultsTrans-iliac-trans-sacral screw fixation at S1 and S2 showed the highest stabilization for horizontal and vertical displacement at the sacral fracture site and reduction of contralateral sacroiliac joint for bending and flexion range of motion by 165% and 121%, respectively. DTSF (Double transiliac rod and screw fixation) model showed highest stabilization in horizontal displacement at the pubic rami fracture site, while the L5_PF_W_CC (L5-Ilium posterior screw fixation with cross connectors) and L5_PF_WO_CC (L5-Ilium posterior screw fixation without cross connectors) showed higher rod stresses, reduced L1-S1 (approximately 28%), and L5-S1 (approximately 90%) range of motion.

conclusionsLonger sacral screw fixations were superior in stabilizing sacral and contralateral sacroiliac joint range of motion. Lumbopelvic fixations displayed a higher degree of stabilization in the horizontal displacement compared to vertical displacement of pubic rami fracture, while also indicating the highest rod stresses. When determining the surgical approach for pelvic ring fractures, patient-specific factors should be accounted for to weigh the advantages and disadvantages for each technique.

Indexed as

finite element analysisfixation techniquesfracture displacementpelvic ring fracturessacroiliac joint

Identifiers

PMID38671770
PMCPMC11048038
OpenAlexW4393865613

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.