DEVELOPMENT OF POLYAXIAL LOCKING PLATE SCREW SYSTEM OF SACROILIAC JOINT_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 FANWeijie , XIEXuesong , ZHOUShuping , ZHANGYonghu

Department of Orthopedics, the First Affiliated Hospital, University of South China, Hengyang Hunan, 421001, P. R. China;

Corresponding author：

FANWeijie, Email: flygreatman@126.com

Keywords：

Sacroiliac joint dislocation; Polyaxial locking plate screw system of sacroiliac joint; Pelvic internal fixation

DOI：

10.7507/1002-1892.20140238

Video：

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Objective To develop an instrument for sacroiliac joint fixation with less injury and less complications. Methods Firstly, 18 adult pelvic specimens (8 males and 10 females) were used to measure the anatomical data related to the locking plates and locking screws on the sacrum and ilium, and the polyaxial locking plate screw system of the sacroiliac joint was designed according to the anatomic data. This system was made of medical titanium alloy. Then 4 adult male plevic specimens were harvested and the experiment was divided into 3 groups:group A (normal pelvic), group B (the dislocated sacroiliac joint fixed with sacroiliac screws), and group C (the dislocated sacroiliac joint fixed with polyaxial locking plate screw system). The vertical displacement of sacroiliac joint under the condition of 0-700 N vertical load and the horizontal displacement on angle under the condition of 0-12 N·m torsional load were compared among the 3 groups by using the biological material test system. Finally, the simulated application test was performed on 1 adult male cadaveric specimen to observe soft tissue injury and the position of the locking plate and screw by X-ray films. Results According to the anatomic data of the sacrum and ilium, the polyaxial locking plate screw system of the sacroiliac joint was designed. The biomechanical results showed that the vertical displacement of the sacroiliac joint under the condition of 0-700 N vertical load in group A was significantly bigger than that in group B and group C (P < 0.05), but there was no significant difference between group B and group C (P>0.05). The horizontal displacement on angle under the condition of 0-12 N·m torsional load in group A was significantly less than that in group B and group C (P < 0.05). The horizontal displacement on angle under the condition of 0-6 N·m torsional load in group B was bigger than that in group C, and the horizontal displacement on angle under the condition of 6-12 N·m torsional load in group B was less than that in group C, but there was no significant difference between group B and group C (P>0.05). The test of simulating application showed that the specimen suffered less soft tissue injury, and this instrument could be implanted precisely and safely. Conclusion The polyaxial locking plate screw system of the sacroiliac joint has the advantages of smaller volume and less injury; polyaxial fixation enables flexible adjustment screw direction. The simulated application test shows satisfactory fixing effect.

Citation： FANWeijie, XIEXuesong, ZHOUShuping, ZHANGYonghu. DEVELOPMENT OF POLYAXIAL LOCKING PLATE SCREW SYSTEM OF SACROILIAC JOINT. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(9): 1092-1095. doi: 10.7507/1002-1892.20140238 Copy

1.	Vigdorchik JM, Esquivel AO, Jin X, et al. Biomechanical stability of a supra-acetabular pedicle screw internal fixation device (INFIX) vs external fixation and plates for vertically unstable pelvic fractures. J Orthop Surg Res, 2012, 27:31.
2.	Vaidya R, Colen R, Vigdorchik J, et al. Treatment of unstable pelvic ring injuries with an internal anterior fixator and posterior fixation:initial clinical series. J Orthop Trauma, 2012, 26(1):1-8.
3.	宋世锋, 彭磊, 肖海涛, 等.经皮骶髂螺钉与骶髂关节前方钢板固定治疗不稳定性骨盆骨折的对比研究.中华骨科杂志, 2011, 31(11):1191-1196.
4.	Salášek M, Pavelka T. Minimally invasive fixation of the pelvic ring with a transiliacal internal fixator. Acta Chir Orthop Traumatol Cech, 2012, 79(4):335-340.
5.	Marmor M, Lynch T, Matityahu A. Superior gluteal artery injury during iliosacral screw placement due to aberrant anatomy. Orthopedics, 2010, 33(2):117-120.
6.	Osterhoff G, Ossendorf C, Wanner GA, et al. Posterior screw fixation in rotationally unstable pelvic ring injuries. Injury, 2011, 42(10):992-996.
7.	Weil YA, Nousiainen MT, Helfet DL. Removal of an il iosacral screw entrapping the L₅ nerve root after failed posterior pelvic ring fixation:a case report. J Orthop Trauma, 2007, 21(6):414-417.
8.	Valente A, Nicodemo A, Bruno A, et al. Cerebrospinal fluid fistulas after iliosacral screw removal in post-traumatic pseudomeningocele. J Orthop Traumatol, 2012, 13(2):111-114.
9.	Mendel T, Noser H, Kuervers J, et al. The influence of sacral morphology on the existence of secure S1 and S2 transverse bone corridors for il iosacroiliac screw fixation. Injury, 2013, 44(12):1773-1779.
10.	尤传飞, 袁峰, 葛保健, 等.经骶1-2侧块螺钉固定的解剖学研究.中国脊柱脊髓杂志, 2012, 22(7):641-644, 650.
11.	刘佳, 孙善全, 倪卫东, 等.骶髂关节前路钢板螺钉固定手术安全区的应用解剖学研究.中国临床解剖学杂志, 2012, 30(3):271-274.
12.	张奉琪, 潘进社, 张英泽, 等.骨盆骨折骶髂关节分离前路钢板固定的应用解剖.中国临床解剖学杂志, 2004, 22(2):120-121.
13.	陈伟, 王满宜, 张奇, 等.三种内固定物固定骨盆后环损伤稳定性的生物力学比较.中华骨科杂志, 2011, 31(11):1232-1238.
14.	Lehmann W, Großterlinden L, Rueger JM. Posterior approaches to the pelvic ring. Unfallchirurg, 2013, 116(3):205-212.
15.	Pavelka T, Salášek M, Weisová D. Complications associated with surgical treatment of pelvic ring fractures. Acta Chir Orthop Traumatol Cech, 2013, 80(3):208-215.
16.	Chen HW, Liu GD, Fei J, et al. Treatment of unstable posterior pelvic ring fracture with percutaneous reconstruction plate and percutaneous sacroiliac screws:a comparative study. J Orthop Sci, 2012, 17(5):580-587.
17.	田素魁, 房晓彬, 王振强, 等.使用TOS装置固定术治疗垂直不稳定型骨盆骨折.实用骨科杂志, 2012, 18(7):598-600.

1. Vigdorchik JM, Esquivel AO, Jin X, et al. Biomechanical stability of a supra-acetabular pedicle screw internal fixation device (INFIX) vs external fixation and plates for vertically unstable pelvic fractures. J Orthop Surg Res, 2012, 27:31.
2. Vaidya R, Colen R, Vigdorchik J, et al. Treatment of unstable pelvic ring injuries with an internal anterior fixator and posterior fixation:initial clinical series. J Orthop Trauma, 2012, 26(1):1-8.
3. 宋世锋, 彭磊, 肖海涛, 等.经皮骶髂螺钉与骶髂关节前方钢板固定治疗不稳定性骨盆骨折的对比研究.中华骨科杂志, 2011, 31(11):1191-1196.
4. Salášek M, Pavelka T. Minimally invasive fixation of the pelvic ring with a transiliacal internal fixator. Acta Chir Orthop Traumatol Cech, 2012, 79(4):335-340.
5. Marmor M, Lynch T, Matityahu A. Superior gluteal artery injury during iliosacral screw placement due to aberrant anatomy. Orthopedics, 2010, 33(2):117-120.
6. Osterhoff G, Ossendorf C, Wanner GA, et al. Posterior screw fixation in rotationally unstable pelvic ring injuries. Injury, 2011, 42(10):992-996.
7. Weil YA, Nousiainen MT, Helfet DL. Removal of an il iosacral screw entrapping the L₅ nerve root after failed posterior pelvic ring fixation:a case report. J Orthop Trauma, 2007, 21(6):414-417.
8. Valente A, Nicodemo A, Bruno A, et al. Cerebrospinal fluid fistulas after iliosacral screw removal in post-traumatic pseudomeningocele. J Orthop Traumatol, 2012, 13(2):111-114.
9. Mendel T, Noser H, Kuervers J, et al. The influence of sacral morphology on the existence of secure S1 and S2 transverse bone corridors for il iosacroiliac screw fixation. Injury, 2013, 44(12):1773-1779.
10. 尤传飞, 袁峰, 葛保健, 等.经骶1-2侧块螺钉固定的解剖学研究.中国脊柱脊髓杂志, 2012, 22(7):641-644, 650.
11. 刘佳, 孙善全, 倪卫东, 等.骶髂关节前路钢板螺钉固定手术安全区的应用解剖学研究.中国临床解剖学杂志, 2012, 30(3):271-274.
12. 张奉琪, 潘进社, 张英泽, 等.骨盆骨折骶髂关节分离前路钢板固定的应用解剖.中国临床解剖学杂志, 2004, 22(2):120-121.
13. 陈伟, 王满宜, 张奇, 等.三种内固定物固定骨盆后环损伤稳定性的生物力学比较.中华骨科杂志, 2011, 31(11):1232-1238.
14. Lehmann W, Großterlinden L, Rueger JM. Posterior approaches to the pelvic ring. Unfallchirurg, 2013, 116(3):205-212.
15. Pavelka T, Salášek M, Weisová D. Complications associated with surgical treatment of pelvic ring fractures. Acta Chir Orthop Traumatol Cech, 2013, 80(3):208-215.
16. Chen HW, Liu GD, Fei J, et al. Treatment of unstable posterior pelvic ring fracture with percutaneous reconstruction plate and percutaneous sacroiliac screws:a comparative study. J Orthop Sci, 2012, 17(5):580-587.
17. 田素魁, 房晓彬, 王振强, 等.使用TOS装置固定术治疗垂直不稳定型骨盆骨折.实用骨科杂志, 2012, 18(7):598-600.

Chinese Journal of Reparative and Reconstructive Surgery

DEVELOPMENT OF POLYAXIAL LOCKING PLATE SCREW SYSTEM OF SACROILIAC JOINT

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