Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 16, 2021; 9(8): 1814-1826
Published online Mar 16, 2021. doi: 10.12998/wjcc.v9.i8.1814
Three-dimensional finite element analysis with different internal fixation methods through the anterior approach
Xian-Jin Xie, Sheng-Lu Cao, Kai Tong, Zi-Yi Zhong, Gang Wang
Xian-Jin Xie, Sheng-Lu Cao, Zi-Yi Zhong, Gang Wang, Department of Orthopaedic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China
Kai Tong, Department of Orthopaedic Surgery, Zhongnan Hospital, Wuhan University, Wuhan 430000, Hubei Province, China
Author contributions: Xie XJ conceived and coordinated the study, designed, performed, and analyzed the experiments, and wrote the paper; Cao SL, Tong K, Zhong ZY, and Wang G carried out the data collection, data analysis, and revised the paper; All authors reviewed the results and approved the final version of the manuscript.
Supported by National Natural Science Foundation of China, No. 81272008.
Institutional review board statement: The study was approved by the ethics committee of Nanfang Hospital, Southern Medical University.
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gang Wang, MD, Doctor, Department of Orthopaedic Surgery, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Baiyun District, Guangzhou 510515, Guangdong Province, China. 664032160@qq.com
Received: September 24, 2020
Peer-review started: September 24, 2020
First decision: December 14, 2020
Revised: January 6, 2021
Accepted: January 25, 2021
Article in press: January 25, 2021
Published online: March 16, 2021
Processing time: 162 Days and 1.9 Hours
Abstract
BACKGROUND

With the modernization of society and transportation in the last decades in China, the incidence of high-energy trauma increased sharply in China, including that of acetabular fractures.

AIM

To establish different finite element models for acetabular posterior column fractures involving the quadrilateral area of the acetabulum.

METHODS

The three-dimensional models of the normal and fractured pelvis and the five internal fixations were established using the computed tomography data of the pelvis of a living volunteer. After the vertebral body model was inserted in the way of origin matching and all cancellous bones were copied using the duplicated cancellous bone model as the subtractive entity, the Boolean operation was performed on the pelvis model to obtain the model of the complete pelvis cortical and cancellous bones.

RESULTS

In the standing position, the maximum stress was 46.21 MPa. In the sitting position, the sacrum bore the simulated gravity load at the upper end. When comparing the five fixations, there were no significant differences in the stress mean values among groups (sitting: P = 0.9794; standing: P = 0.9741). In terms of displacement, the average displacement of the internal iliac plate group was smaller than that of the spring plate group (P = 0.002), and no differences were observed between the other pairs of groups (all P > 0.05). In the standing position, there were no significant differences in the mean value of displacement among the groups (P = 0.2985). It can be seen from the stress nephogram of the internal fixations in different positions that the stress of the internal fixation was mainly concentrated in the fracture segment.

CONCLUSION

There were no significant differences among the fixations for acetabular posterior column fractures involving the quadrilateral area of the acetabulum.

Keywords: Acetabulum; Hip fractures; Analysis; Finite element; Fracture fixation; Orthopedic fixation devices

Core Tip: Acetabular fractures are challenging, especially fractures of the quadrilateral area. Obtaining a three-dimensional finite element model of the pelvis is an effective method for biomechanical research and can provide some basis for the biomechanical characteristics of different fixation methods. This study aimed to establish different finite element models (in simulated standing and sitting positions) of the internal iliac plate, combined plate of anterior and posterior columns, triangle plate, row nail blocking, and spring plate for acetabular posterior column fractures involving the quadrilateral area of the acetabulum. The results suggest that there are no significant differences among the fixations.