Published online Mar 16, 2021. doi: 10.12998/wjcc.v9.i8.1814
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
With the modernization of society and transportation in the last several decades in China, the incidence of high-energy trauma, including acetabular fractures, has increased sharply in China.
The treatment of acetabular fractures is challenging, especially for 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 a basis for the biomechanical characteristics of different fixation methods applied in acetabular posterior column fracture.
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 three-dimensional models of the normal and fractured pelvis and the five internal fixations were established using computed tomography data of the pelvis of a living volunteer.
In the standing position, the maximum stress was 46.210 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. The average displacement of the internal iliac plate group was smaller than that of the spring plate group, and no differences were observed between the other pairs of groups. In the standing position, there were no significant differences in the mean value of displacement among the groups. Of note, the data were obtained from the model constructed from a single individual. The results should be validated in multiple individuals.
There were no significant differences among the fixations for acetabular posterior column fractures involving the quadrilateral area of the acetabulum.
The results provide a basis for the biomechanical characteristics of acetabular posterior column fracture fixation. Nevertheless, future studies should examine patients with different characteristics (e.g., elderly, female, or osteoporotic) and patients with different types of fractures because simple posterior column fracture is not commonly seen, and this fracture model cannot satisfy the biomechanical studies of all kinds of posterior column fractures.