BIOMECHANICS STUDY ON ACETABULAR POSTERIOR WALL FRACTURE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

TANGYang ¹ , HUXiaopeng ¹ ,  LUXiongwei ¹ , ZHANGYuntong ² , ZHANGChuncai ² , WANGPanfeng ² , ZHAOXue ²

1. Department of Orthopaedics, Shanghai 3rd People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 201999, P. R. China;
2. Department of Orthopaedics, the Affiliated Changhai Hospital of the Second Military Medical University, Shanghai, 201999, P. R. China;

Corresponding?author：

LUXiongwei, Email: 6169261@qq.com

Keywords：

Acetabular fracture; Superior-posterior wall; Biomechanics; Displacement

DOI：

10.7507/1002-1892.20150200

Video：

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Objective To study the experimental biomechanics of acetabular posterior wall fractures so as to provide theoretical basis for its clinical treatment. Methods Six formalin-preserved cadaveric pelvises were divided into groups A and B (n=3). The fracture models of superior-posterior wall and inferior-posterior wall of the acetabulum were created on both hips in group A;fractures were fixed with two interfragmentary screws and a locking reconstruction plate. The fracture models of superior-posterior wall of acetabulum were created on both hips in group B;fractures were fixed with two interfragmentary screws and a locking reconstruction plate at one side, and with acetabular tridimensional memory fixation system (ATMFS) at the other side. The biomechanical testing machine was used to load to 1 500 N at 10 mm/min speed for 30 seconds. The displacement of superior and inferior fracture sites was analyzed with the digital image correlation technology. Results No fracture or internal fixation breakage occurred during loading and measuring;the displacement valuess of the upper and lower fracture lines were below 2 mm (the clinically tolerable maximum value) in 2 groups. In group A, the displacement values of the upper and lower fracture lines at superior-posterior wall fracture site were significantly higher than those at inferior-posterior wall fracture site (P<0.01), and the displacement values of the upper fracture line were significantly higher than those of lower fracture line (P<0.01) in two fracture types. In group B, the displacement values of the upper and lower fracture lines at the side fixed with screws and a locking reconstruction plate were similar to the values at the side fixed with ATMFS, all being close to 2 mm;the displacement values of the upper fracture line were significantly higher than those of lower fracture line (P<0.05) in two fixation types. Conclusion The actual biomechanical effect of the superior-posterior wall of acetabulum is much greater than that of the inferior-posterior wall of acetabulum and they should be discriminated, which might be the reasons of reduction loss, femoral head subluxation, and traumatic arthritis during follow-up.

Citation： TANGYang, HUXiaopeng, LUXiongwei, ZHANGYuntong, ZHANGChuncai, WANGPanfeng, ZHAOXue. BIOMECHANICS STUDY ON ACETABULAR POSTERIOR WALL FRACTURE. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(8): 925-930. doi: 10.7507/1002-1892.20150200 Copy

1.	Sawaguchi T,Brown TD,Rubash HE,et al.Stability of acetabular fractures after internal fixation.A cadaveric study.Acta Orthop Scand,1984,55(6):601-605.
2.	王葵光,鄭祖根,沈憶新.三維CT重建在髖臼骨折診治中的應用價值.山東醫藥,2003,43(3):23-24.
3.	王慶賢.髖臼骨折生物力學研究進展.國外醫學:骨科學分冊,2001,22(4):217-220.
4.	Letournel E,Judet R.Fractures of the Acetabulum.2nd eds.Berlin:Springer-Verlag,1993:77-85.
5.	Pennal G,Davidson J,Garside H,et al.Results of treatment of acetabular fractures.Clin Orthop Relat Res,1980,(151):115-123.
6.	Olson SA,Bay BK,Hamel A.Biomechanics of the hip joint and the effects of fracture of the acetabulum.Clin Orthop Relat Res,1997,(339):92-104.
7.	Shazar N,Brumback RJ,Novak VP,et al.Biomechanical evaluation of transverse acetabular fracture fixation.Clin Orthop Relat Res,1998,(352):215-222.
8.	宋朝暉,張英澤,潘進社,等.髖臼后壁骨折對髖臼與股骨頭之間應力的影響.中華創傷雜志,2002,18(2):91-93.
9.	黃慶森,單文缽,尚天裕,等.骨骼系統基本生物力學.天津:天津科學技術出版社,1983:164.
10.	Olson SA,Bay BK,Chapman MW,et al.Biomechanical consequences of fracture and repair of the posterior wall of the acetabulum.J Bone Joint Surg (Am),1995,77(8):1184-1192.
11.	Baumgaertner MR.Fractures of the posterior wall of the acetabulum.J Am Acad Orthop Surg,1999,7(1):54-65.
12.	Matta JM.Fractures of the acetabulum:accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury.J Bone Joint Surg (Am),1996,78(11):1632-1645.
13.	Mitsionis GI,Lykissas MG,Motsis E,et al.Surgical management of posterior hip dislocations associated with posterior wall acetabular fracture:a study with a minimum follow-up of 15 years.J Orthop Trauma,2012,26(8):460-465.
14.	張春才,許碩貴,禹寶慶,等.髖臼粉碎性骨折合并壓縮性缺損的治療與對策.中華創傷骨科雜志,2005,7(11):1010-1014.

1. Sawaguchi T,Brown TD,Rubash HE,et al.Stability of acetabular fractures after internal fixation.A cadaveric study.Acta Orthop Scand,1984,55(6):601-605.
2. 王葵光,鄭祖根,沈憶新.三維CT重建在髖臼骨折診治中的應用價值.山東醫藥,2003,43(3):23-24.
3. 王慶賢.髖臼骨折生物力學研究進展.國外醫學:骨科學分冊,2001,22(4):217-220.
4. Letournel E,Judet R.Fractures of the Acetabulum.2nd eds.Berlin:Springer-Verlag,1993:77-85.
5. Pennal G,Davidson J,Garside H,et al.Results of treatment of acetabular fractures.Clin Orthop Relat Res,1980,(151):115-123.
6. Olson SA,Bay BK,Hamel A.Biomechanics of the hip joint and the effects of fracture of the acetabulum.Clin Orthop Relat Res,1997,(339):92-104.
7. Shazar N,Brumback RJ,Novak VP,et al.Biomechanical evaluation of transverse acetabular fracture fixation.Clin Orthop Relat Res,1998,(352):215-222.
8. 宋朝暉,張英澤,潘進社,等.髖臼后壁骨折對髖臼與股骨頭之間應力的影響.中華創傷雜志,2002,18(2):91-93.
9. 黃慶森,單文缽,尚天裕,等.骨骼系統基本生物力學.天津:天津科學技術出版社,1983:164.
10. Olson SA,Bay BK,Chapman MW,et al.Biomechanical consequences of fracture and repair of the posterior wall of the acetabulum.J Bone Joint Surg (Am),1995,77(8):1184-1192.
11. Baumgaertner MR.Fractures of the posterior wall of the acetabulum.J Am Acad Orthop Surg,1999,7(1):54-65.
12. Matta JM.Fractures of the acetabulum:accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury.J Bone Joint Surg (Am),1996,78(11):1632-1645.
13. Mitsionis GI,Lykissas MG,Motsis E,et al.Surgical management of posterior hip dislocations associated with posterior wall acetabular fracture:a study with a minimum follow-up of 15 years.J Orthop Trauma,2012,26(8):460-465.
14. 張春才,許碩貴,禹寶慶,等.髖臼粉碎性骨折合并壓縮性缺損的治療與對策.中華創傷骨科雜志,2005,7(11):1010-1014.

Chinese Journal of Reparative and Reconstructive Surgery

BIOMECHANICS STUDY ON ACETABULAR POSTERIOR WALL FRACTURE

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