Third-Generation Dynamic Anterior Plate-Screw System for Quadrilateral Fractures: Digital Design Based on 834 Pelvic Measurements
Abstract
:1. Introduction
2. Materials and Methods
2.1. Direct Measurement of Pelvic Specimens
2.2. Digital Measurement of the Three-Dimensional (3D) Reconstruction Model of the Pelvis
2.2.1. Pelvic CT Scan and 3D Reconstruction
2.2.2. Digital Morphological Measurement
2.3. Collection of Pelvic 3D Reconstruction Data from Different Regions of China
2.4. Design and Verification of the Third Generation DAPSQ Plate
2.4.1. Process of Plate Design
2.4.2. Reliability Verification
2.5. Statistical Analysis
3. Results
3.1. Comparison of the Two Measurement Methods
3.2. Overall Measurement Results
3.3. Different Models of Third-Generation DAPSQ Plate and Verification
4. Discussion
4.1. The Application of Mimics Software in the Quadrilateral Plate Research
4.2. DAPSQ Plate Trajectory
4.3. Comparison of Plate Trajectory in Different Chinese Regions
4.4. The Design of Third-Generation DAPSQ Plate
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Maia, M.S.; Santos, D.C.; de Queiroga, D.M.; de Oliveira Castro, C.; Silva, R.M.; Reis, A.C.; Ducatti, A.C. Epidemiological analysis on acetabular fractures. Rev. Bras. Ortop. 2015, 46, 23–26. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Firoozabadi, R.; Cross, W.W.; Krieg, J.C.; Routt, M.L.C. Acetabular Fractures in the Senior Population–Epidemiology, Mortality and Treatments. Arch. Bone Jt. Surg. 2017, 5, 96–102. [Google Scholar] [PubMed]
- Panella, A.; Solarino, G.; Vicenti, G.; Bizzoca, D.; Baglioni, M.; Fortunato, F.; Maruccia, F.; Notarnicola, A.; Piazzolla, A.; Pascarella, R.; et al. Internal fixation of acetabular quadrilateral plate fractures in elderly patients: Could the fracture reduction quality affect their functional recovery? Aging Clin. Exp. Res. 2021, 33, 1627–1633. [Google Scholar] [CrossRef] [PubMed]
- Judet, R.; Judet, J.; Letournel, E. Fractures of the Acetabulum: Classification and Surgical Approaches for Oreduction, Preliminary Report. J. Bone Jt. Surg. Am. 1964, 46, 1615–1646. [Google Scholar] [CrossRef]
- Eichenholtz, S.N.; Strk, R.M. Central Acetabular Fractures: A Review of Thirty-five Cases. J. Bone Jt. Surg. Am. 1964, 46, 695–714. [Google Scholar] [CrossRef]
- Carnesale, P.G.; Stewart, M.J.; Barnes, S.N. Acetabular Disruption and Central Fracture-dislocation of the Hip. A Long-term Study. J. Bone Jt. Surg. Am. 1975, 57, 1054–1059. [Google Scholar] [CrossRef]
- Gay, S.B.; Sistrom, C.; Wang, G.J.; Kahler, D.A.; Boman, T.; McHugh, N.; Goitz, H.T. Percutaneous Screw Fixation of Acetabular Fractures with CT Guidance: Preliminary Results of a New Technique. AJR Am. J. Roentgenol. 1992, 158, 819–822. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Farid, Y.R. Cerclage Wire-plate Composite for Fixation of Quadrilateral Plate Fractures of the Acetabulum: A Checkrein and Pulley Technique. J. Orthop. Trauma 2010, 24, 323–328. [Google Scholar] [CrossRef]
- Tosounidis, T.H.; Gudipati, S.; Panteli, M.; Kanakaris, N.K.; Giannoudis, P.V. The Use of Buttress Plates in the Management of Acetabular Fractures with Quadrilateral Plate Involvement: Is it Still a Valid Option? Int. Orthop. 2015, 39, 2219–2226. [Google Scholar] [CrossRef] [PubMed]
- Richter, H.; Hutson, J.J.; Zych, G. The Use of Spring Plates in the Internal Fixation of Acetabular Fractures. J. Orthop. Trauma 2004, 18, 179–181. [Google Scholar] [CrossRef]
- Karim, M.A.; Abdelazeem, A.H.; Youness, M.; El Nahal, W.A. Fixation of Quadrilateral Plate Fractures of the Acetabulum Uthe Buttress Screw: A Novel Technique. Injury 2017, 48, 1813–1818. [Google Scholar] [CrossRef] [PubMed]
- Ciolli, G.; De Mauro, D.; Rovere, G.; Smakaj, A.; Marino, S.; Are, L.; El Ezzo, O.; Liuzza, F. Anterior Intrapelvic Approach and Suprapectineal Quadrilateral Surface Plate for Acetabular Fractures with Anterior Involvement: A Retrospective Study of 34 Patients. BMC Musculoskelet. Disord. 2021, 22, 1060. [Google Scholar] [CrossRef] [PubMed]
- Zha, G.C.; Tulumuhan, D.M.; Wang, T.; Wan, G.Y.; Wang, Y.; Sun, J.Y. A New Internal Fixation Technique for Acetabular Fractures Involving the Quadrilateral Plate. Orthop. Traumatol. Surg. Res. 2020, 106, 855–861. [Google Scholar] [CrossRef] [PubMed]
- Veliceasa, B.; Filip, A.; Pertea, M.; Popescu, D.; Carp, C.; Alexa, O. Omega Plate for the Treatment of Acetabular Fractures Involving the Quadrilateral Plate. Exp. Ther. Med. 2021, 22, 1064. [Google Scholar] [CrossRef]
- Zhang, R.; Yin, Y.; Li, S.; Jin, L.; Guo, J.; Hou, Z.; Zhang, Y. Fixation of Displaced Acetabular Fractures with an Anatomic Quadrilateral Surface Plate through the Stoppa Approach. Orthopedics 2019, 42, e180–e186. [Google Scholar] [CrossRef] [PubMed]
- Matta, J.M. Fractures of the Acetabulum: Accuracy of Reduction and Clinical Results in Patients Managed Operatively within Three Weeks After the Injury. J. Bone Jt. Surg. Am. 1996, 78, 1632–1645. [Google Scholar] [CrossRef]
- Wu, H.; Shang, R.; Cai, X.; Liu, X.; Song, C.; Chen, Y. Single Ilioinguinal Approach to Treat Complex Acetabular Fractures with Quadrilateral Plate Involvement: Outcomes Using a Novel Dynamic Anterior Plate-screw System. Orthop. Surg. 2020, 12, 488–497. [Google Scholar] [CrossRef] [Green Version]
- Wu, Y.D.; Cai, X.H.; Liu, X.M.; Zhang, H.X. Biomechanical Analysis of the Acetabular Buttress-plate: Are Complex Acetabular Fractures in the Quadrilateral Area Stable after Treatment with Anterior Construct Plate-1/3 Tube Buttress Plate Fixation? Clinics 2013, 68, 1028–1033. [Google Scholar] [CrossRef]
- Wu, H.Y.; Shao, Q.P.; Song, C.J.; Shang, R.R.; Liu, X.M.; Cai, X.H. Personalized Three-Dimensional Printed Anterior Titanium Plate to Treat Double-Column Acetabular Fractures: A Retrospective Case-Control Study. Orthop. Surg. 2020, 12, 1212–1222. [Google Scholar] [CrossRef]
- Assi, C.; Bonnel, F.; Mansour, J.; Mares, O.; Yammine, K. Morphometric Analysis of All 24 Hip Muscles: A Cadaveric Study of 18 Hip Specimens with Proposal of a New Classification of Muscles. Surg. Radiol. Anat. 2021, 43, 63–72. [Google Scholar] [CrossRef]
- Ek, E.T.; Philpott, A.J.; Flynn, J.N.; Richards, N.; Hardidge, A.J.; Rotstein, A.H.; Wood, A.D. Characterization of the Proximal Long Head of Biceps Tendon Anatomy Using Magnetic Resonance Imaging: Implications for Biceps Tenodesis. Am. J. Sports Med. 2021, 49, 346–352. [Google Scholar] [CrossRef] [PubMed]
- Li, S.; Li, H.; Hu, Y.; Zhu, S.; Xu, Z.; Zhang, Q.; Yang, Y.; Wang, Z.; Xu, J. Ultrasound for Measuring the Cross-Sectional Area of Biceps Brachii Muscle in Sarcopenia. Int. J. Med. Sci. 2020, 17, 2947–2953. [Google Scholar] [CrossRef] [PubMed]
- Lenchik, L.; Barnard, R.; Boutin, R.D.; Kritchevsky, S.B.; Chen, H.; Tan, J.; Cawthon, P.M.; Weaver, A.A.; Hsu, F.C. Automated Muscle Measurement on Chest CT Predicts All-Cause Mortality in Older Adults From the National Lung Screening Trial. J. Gerontol. A Biol. Sci. Med. Sci. 2021, 76, 277–285. [Google Scholar] [CrossRef] [PubMed]
- Zhang, S.; Su, W.; Luo, Q.; Leung, F.; Chen, B. Measurement of the “Safe Zone” and the “Dangerous Zone” for the Screw Placement on the Quadrilateral Surface in the Treatment of Pelvic and Acetabular Fractures with Stoppa Approach by Computational 3D Technology. Biomed. Res. Int. 2014, 2014, 386950. [Google Scholar] [CrossRef] [Green Version]
- Guo, J.; Dong, W.; Zhou, Y.; Hu, J.; Ye, P.; Chen, W.; Zhang, Y.; Hou, Z. Differences in Fixation to Young and Elderly Quadrilateral Surfaces with Anatomic Quadrilateral Surface Plate (AQSP) Based on Cortical Thickness Morphological Results. J. Orthop. Surg. Res. 2022, 17, 143. [Google Scholar] [CrossRef]
- Zheng, Y.; Chen, J.; Yang, S.; Ke, X.; Xu, D.; Wang, G.; Cai, X.; Liu, X. Application of Computerized Virtual Preoperative Planning Procedures in Comminuted Posterior Wall Acetabular Fractures Surgery. J. Orthop. Surg. Res. 2022, 17, 51. [Google Scholar] [CrossRef]
- Maini, L.; Verma, T.; Sharma, A.; Sharma, A.; Mishra, A.; Jha, S. Evaluation of Accuracy of Virtual Surgical Planning for Patient-specific Pre-contoured Plate in Acetabular Fracture Fixation. Arch. Orthop. Trauma Surg. 2018, 138, 495–504. [Google Scholar] [CrossRef] [PubMed]
- Huang, G.; Chen, K.; Wang, Y.; Guo, X. Finite Element Analysis of the Union Plate in Treating Elderly Acetabular Fracture Patients. J. Orthop. Surg. Res. 2022, 17, 56. [Google Scholar] [CrossRef]
- Anderson, A.E.; Peters, C.L.; Tuttle, B.D.; Weiss, J.A. Subject-specific Finite Element Model of the Pelvis: Development, Validation and Sensitivity Studies. J. Biomech. Eng. 2005, 127, 364–373. [Google Scholar] [CrossRef] [Green Version]
- Grosland, N.M.; Shivanna, K.H.; Magnotta, V.A.; Kallemeyn, N.A.; DeVries, N.A.; Tadepalli, S.C.; Lisle, C. IA-FEMesh: An Open-source, Interactive, Multiblock Approach to Anatomic Finite Element Model Development. Comput. Methods Programs Biomed. 2009, 94, 96–107. [Google Scholar] [CrossRef]
- Wu, H.; Song, C.; Shang, R.; Shao, Q.; Liu, X.; Zhang, H.; Cai, X. Double Column Acetabular Fractures Fixation Using a Novel Dynamic Anterior Plate-screw System: A Biomechanical Analysis. Injury 2021, 52, 407–413. [Google Scholar] [CrossRef]
- Lei, J.; Zhang, Y.; Wu, G.; Wang, Z.; Cai, X. The Influence of Pelvic Ramus Fracture on the Stability of Fixed Pelvic Complex Fracture. Comput. Math. Methods Med. 2015, 2015, 790575. [Google Scholar] [CrossRef] [Green Version]
- Delprete, H. Pelvic Inlet Shape is not As Dimorphic As Previously Suggested. Anat. Rec. 2017, 300, 706–715. [Google Scholar] [CrossRef] [Green Version]
- Coleman, W.H. Sex Differences in the Growth of the Human Bony Pelvis. Am. J. Phys. Anthropol. 1969, 31, 125–151. [Google Scholar] [CrossRef]
Groups | Age | Intact Pelvis | Left Pelvis | Right Pelvis | Hemilateral Pelvis | Total |
---|---|---|---|---|---|---|
Male | 41.48 ± 16.18 | 190 | 55 | 55 | 490 | 300 |
Female | 47.09 ± 16.53 | 139 | 32 | 34 | 344 | 204 |
Groups | Pubic Region | Quadrilateral Region | Ilium Region | Total Length |
---|---|---|---|---|
Direct | 60.38 ± 3.90 | 66.08 ± 3.19 | 89.19 ± 4.38 | 215.65 ± 8.23 |
Digital | 60.60 ± 3.79 | 67.48 ± 4.63 | 88.20 ± 6.03 | 216.23 ± 11.41 |
t | 0.457 | 1.988 | 1.006 | 0.516 |
p | >0.05 | >0.05 | >0.05 | >0.05 |
Groups | Pubic Region | Quadrilateral Region | Ilium Region | Total Length |
---|---|---|---|---|
Northeast China (n = 93) | 61.89 ± 4.55 | 71.19 ± 5.48 | 84.94 ± 6.55 | 218.03 ± 10.14 |
Central China (n = 549) | 61.18 ± 5.29 | 69.12 ± 5.25 * | 84.77 ± 6.62 | 215.07 ± 9.86 * |
South China (n = 177) | 60.03 ± 5.78 | 67.94 ± 4.98 *# | 83.10 ± 5.56 | 211.07 ± 9.93 *# |
F-value | 4.560 | 11.868 | 4.892 | 17.378 |
p-value | 0.11 | <0.001 | 0.08 | <0.001 |
Groups | Pubic region | Quadrilateral Region | Ilium Region | Total Length |
---|---|---|---|---|
Male (n = 490) | 58.64 ± 4.69 | 69.72 ± 5.17 | 86.85 ± 6.03 | 215.20 ± 10.30 |
Female (n = 344) | 64.20 ± 4.61 | 68.31 ± 5.38 | 80.86 ± 5.19 | 213.37 ± 9.80 |
t | 17.846 | 5.358 | 14.506 | 2.342 |
p-value | <0.001 | <0.001 | <0.001 | 0.02 |
Models | Total Length | Pubic Region | Quadrilateral Region | Iliac Region | |
---|---|---|---|---|---|
Small size | A1 | 194 | 55 | 61 | 78 |
A2 | 194 | 51 | 66 | 77 | |
Medium size | B1 | 214 | 51 | 67 | 86 |
B2 | 214 | 56 | 73 | 84 | |
Large size | C1 | 234 | 66 | 74 | 94 |
C2 | 234 | 62 | 80 | 92 |
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Shang, R.; Wu, H.; Zhou, L.; Song, C.; Shao, Q.; Liu, X.; Cai, X. Third-Generation Dynamic Anterior Plate-Screw System for Quadrilateral Fractures: Digital Design Based on 834 Pelvic Measurements. Medicina 2023, 59, 211. https://doi.org/10.3390/medicina59020211
Shang R, Wu H, Zhou L, Song C, Shao Q, Liu X, Cai X. Third-Generation Dynamic Anterior Plate-Screw System for Quadrilateral Fractures: Digital Design Based on 834 Pelvic Measurements. Medicina. 2023; 59(2):211. https://doi.org/10.3390/medicina59020211
Chicago/Turabian StyleShang, Ranran, Haiyang Wu, Li Zhou, Chengjing Song, Qipeng Shao, Ximing Liu, and Xianhua Cai. 2023. "Third-Generation Dynamic Anterior Plate-Screw System for Quadrilateral Fractures: Digital Design Based on 834 Pelvic Measurements" Medicina 59, no. 2: 211. https://doi.org/10.3390/medicina59020211