Is a Washer a Mandatory Component in Young Trauma Patients with S1-S2 Iliosacral Screw Fixation of Posterior Pelvis Ring Injuries? A Biomechanical Study
Abstract
:1. Introduction
Purpose
2. Materials and Methods
- Set 1:
- Group PT w/: Fixation of the posterior pelvis ring with two 7.3 mm partially threaded short cannulated self-tapping screws (lengths: 90 mm for S1 and 65 mm for S2) and washers (diameter 13.0 mm, thickness 6.6 mm).
- Group PT w/o: Fixation of the posterior pelvis ring with two 7.3 mm partially threaded short cannulated self-tapping screws (lengths: 90 mm for S1 and 65 mm for S2) without washers.
- Set 2:
- Group FT w/: Fixation of the posterior pelvis ring with two 7.3 mm fully threaded short cannulated self-tapping screws (lengths: 90 mm for S1 and 65 mm for S2) and washers (diameter 13.0 mm, thickness 6.6 mm).
- Group FT w/o: Fixation of the posterior pelvis ring with two 7.3 mm fully threaded short cannulated self-tapping screws (lengths: 90 mm for S1 and 65 mm for S2) without washers.
- Set 3:
- Group TS w/: Fixation of the posterior pelvis ring with two 7.3 mm fully threaded long transsacral cannulated self-tapping screws (lengths: 175 mm for S1 and 160 mm for S2) and washers (diameter 13.0 mm, thickness 6.6 mm).
- Group TS w/o: Fixation of the posterior pelvis ring with two 7.3 mm fully threaded long transsacral cannulated self-tapping screws (lengths: 175 mm for S1 and 160 mm for S2) without washers.
2.1. Biomechanical Testing
2.2. Data Acquisition & Analysis
3. Results
4. Discussion
- Partially threaded short and fully threaded long transsacral screws demonstrated equivalent biomechanical stability under dynamic loading disregarding whether a washer was used or not.
- Omission of the washer led to a significantly diminished biomechanical stability under dynamic loading with fully threaded short screws.
Strength & Limitations
5. Conclusions
Author Contributions
Funding
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Parameter | Group | Cycles | p-Value Groups | ||
---|---|---|---|---|---|
1000 | 2000 | 3000 | |||
Gap angle (°) | PT w/ | 0.50 (0.39) | 0.84 (0.66) | 1.19 (0.87) | 0.751 |
PT w/o | 0.47 (0.20) | 0.92 (0.36) | 1.45 (0.56) | ||
FT w/ | 0.28 (0.30) | 0.74 (0.50) | 1.30 (0.65) | 0.028 | |
FT w/o | 1.31 (0.49) | 3.52 (2.04) | 6.46 (4.47) | ||
TS w/ | 2.68 (2.33) | 3.67 (2.58) | 4.84 (2.76) | 0.236 | |
TS w/o | 1.26 (1.07) | 2.26 (1.43) | 3.23 (1.67) | ||
p-value over cycles | ≤0.038 | ||||
Flexion (°) | PT w/ | 1.09 (1.31) | 2.47 (2.27) | 3.22 (2.61) | 0.973 |
PT w/o | 0.96 (0.30) | 2.10 (0.71) | 3.81 (0.77) | ||
FT w/ | 0.87 (0.27) | 1.80 (0.58) | 2.90 (0.90) | 0.083 | |
FT w/o | 3.32 (2.62) | 6.03 (5.03) | 9.91 (6.80) | ||
TS w/ | 4.47 (3.24) | 6.65 (4.13) | 10.63 (5.94) | 0.132 | |
TS w/o | 2.23 (1.77) | 3.93 (2.62) | 5.62 (3.53) | ||
p-value over cycles | ≤0.042 | ||||
Screw tilt ilium (°) | PT w/ | 0.68 (0.57) | 1.38 (0.88) | 1.92 (1.02) | 0.452 |
PT w/o | 0.71 (0.13) | 1.48 (0.27) | 2.59 (0.27) | ||
FT w/ | 0.50 (0.23) | 1.13 (0.48) | 1.87 (0.75) | 0.011 | |
FT w/o | 2.12 (1.05) | 5.25 (2.64) | 9.34 (4.47) | ||
TS w/ | 3.17 (2.24) | 4.73 (2.78) | 7.26 (3.87) | 0.232 | |
TS w/o | 1.88 (1.25) | 3.30 (1.82) | 4.75 (2.29) | ||
p-value over cycles | ≤0.011 | ||||
Screw tip cutout (mm) | PT w/ | 0.12 (0.07) | 0.23 (0.18) | 0.28 (0.22) | 0.139 |
PT w/o | 0.09 (0.07) | 0.23 (0.15) | 0.60 (0.09) | ||
FT w/ | 0.17 (0.09) | 0.35 (0.08) | 0.37 (0.22) | 0.121 | |
FT w/o | 0.54 (0.48) | 0.98 (1.02) | 1.76 (1.27) | ||
TS w/ | 0.57 (0.37) | 1.33 (0.90) | 2.96 (2.02) | 0.742 | |
TS w/o | 0.89 (1.05) | 1.51 (1.29) | 1.82 (1.96) | ||
p-value over cycles | ≥0.216 (PT w/, FT/w, TS/w) ≤0.023 (PT w/o, FT w/o, TS w/o) |
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Berk, T.; Zderic, I.; Schwarzenberg, P.; Pastor, T.; Halvachizadeh, S.; Richards, G.; Gueorguiev, B.; Pape, H.-C. Is a Washer a Mandatory Component in Young Trauma Patients with S1-S2 Iliosacral Screw Fixation of Posterior Pelvis Ring Injuries? A Biomechanical Study. Medicina 2023, 59, 1379. https://doi.org/10.3390/medicina59081379
Berk T, Zderic I, Schwarzenberg P, Pastor T, Halvachizadeh S, Richards G, Gueorguiev B, Pape H-C. Is a Washer a Mandatory Component in Young Trauma Patients with S1-S2 Iliosacral Screw Fixation of Posterior Pelvis Ring Injuries? A Biomechanical Study. Medicina. 2023; 59(8):1379. https://doi.org/10.3390/medicina59081379
Chicago/Turabian StyleBerk, Till, Ivan Zderic, Peter Schwarzenberg, Torsten Pastor, Sascha Halvachizadeh, Geoff Richards, Boyko Gueorguiev, and Hans-Christoph Pape. 2023. "Is a Washer a Mandatory Component in Young Trauma Patients with S1-S2 Iliosacral Screw Fixation of Posterior Pelvis Ring Injuries? A Biomechanical Study" Medicina 59, no. 8: 1379. https://doi.org/10.3390/medicina59081379