BIOMECHANICS STUDY ON ACETABULAR POSTERIOR WALL FRACTURE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

TANGYang ¹ , HUXiaopeng ¹ ,  LUXiongwei ¹ , ZHANGYuntong ² , ZHANGChuncai ² , WANGPanfeng ² , ZHAOXue ²

1. Department of Orthopaedics, Shanghai 3rd People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 201999, P. R. China;
2. Department of Orthopaedics, the Affiliated Changhai Hospital of the Second Military Medical University, Shanghai, 201999, P. R. China;

Corresponding author：

LUXiongwei, Email: 6169261@qq.com

Keywords：

Acetabular fracture; Superior-posterior wall; Biomechanics; Displacement

DOI：

10.7507/1002-1892.20150200

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Objective To study the experimental biomechanics of acetabular posterior wall fractures so as to provide theoretical basis for its clinical treatment. Methods Six formalin-preserved cadaveric pelvises were divided into groups A and B (n=3). The fracture models of superior-posterior wall and inferior-posterior wall of the acetabulum were created on both hips in group A;fractures were fixed with two interfragmentary screws and a locking reconstruction plate. The fracture models of superior-posterior wall of acetabulum were created on both hips in group B;fractures were fixed with two interfragmentary screws and a locking reconstruction plate at one side, and with acetabular tridimensional memory fixation system (ATMFS) at the other side. The biomechanical testing machine was used to load to 1 500 N at 10 mm/min speed for 30 seconds. The displacement of superior and inferior fracture sites was analyzed with the digital image correlation technology. Results No fracture or internal fixation breakage occurred during loading and measuring;the displacement valuess of the upper and lower fracture lines were below 2 mm (the clinically tolerable maximum value) in 2 groups. In group A, the displacement values of the upper and lower fracture lines at superior-posterior wall fracture site were significantly higher than those at inferior-posterior wall fracture site (P<0.01), and the displacement values of the upper fracture line were significantly higher than those of lower fracture line (P<0.01) in two fracture types. In group B, the displacement values of the upper and lower fracture lines at the side fixed with screws and a locking reconstruction plate were similar to the values at the side fixed with ATMFS, all being close to 2 mm;the displacement values of the upper fracture line were significantly higher than those of lower fracture line (P<0.05) in two fixation types. Conclusion The actual biomechanical effect of the superior-posterior wall of acetabulum is much greater than that of the inferior-posterior wall of acetabulum and they should be discriminated, which might be the reasons of reduction loss, femoral head subluxation, and traumatic arthritis during follow-up.

Citation： TANGYang, HUXiaopeng, LUXiongwei, ZHANGYuntong, ZHANGChuncai, WANGPanfeng, ZHAOXue. BIOMECHANICS STUDY ON ACETABULAR POSTERIOR WALL FRACTURE. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(8): 925-930. doi: 10.7507/1002-1892.20150200 Copy

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3.	王庆贤.髋臼骨折生物力学研究进展.国外医学:骨科学分册,2001,22(4):217-220.
4.	Letournel E,Judet R.Fractures of the Acetabulum.2nd eds.Berlin:Springer-Verlag,1993:77-85.
5.	Pennal G,Davidson J,Garside H,et al.Results of treatment of acetabular fractures.Clin Orthop Relat Res,1980,(151):115-123.
6.	Olson SA,Bay BK,Hamel A.Biomechanics of the hip joint and the effects of fracture of the acetabulum.Clin Orthop Relat Res,1997,(339):92-104.
7.	Shazar N,Brumback RJ,Novak VP,et al.Biomechanical evaluation of transverse acetabular fracture fixation.Clin Orthop Relat Res,1998,(352):215-222.
8.	宋朝晖,张英泽,潘进社,等.髋臼后壁骨折对髋臼与股骨头之间应力的影响.中华创伤杂志,2002,18(2):91-93.
9.	黄庆森,单文钵,尚天裕,等.骨骼系统基本生物力学.天津:天津科学技术出版社,1983:164.
10.	Olson SA,Bay BK,Chapman MW,et al.Biomechanical consequences of fracture and repair of the posterior wall of the acetabulum.J Bone Joint Surg (Am),1995,77(8):1184-1192.
11.	Baumgaertner MR.Fractures of the posterior wall of the acetabulum.J Am Acad Orthop Surg,1999,7(1):54-65.
12.	Matta JM.Fractures of the acetabulum:accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury.J Bone Joint Surg (Am),1996,78(11):1632-1645.
13.	Mitsionis GI,Lykissas MG,Motsis E,et al.Surgical management of posterior hip dislocations associated with posterior wall acetabular fracture:a study with a minimum follow-up of 15 years.J Orthop Trauma,2012,26(8):460-465.
14.	张春才,许硕贵,禹宝庆,等.髋臼粉碎性骨折合并压缩性缺损的治疗与对策.中华创伤骨科杂志,2005,7(11):1010-1014.

1. Sawaguchi T,Brown TD,Rubash HE,et al.Stability of acetabular fractures after internal fixation.A cadaveric study.Acta Orthop Scand,1984,55(6):601-605.
2. 王葵光,郑祖根,沈忆新.三维CT重建在髋臼骨折诊治中的应用价值.山东医药,2003,43(3):23-24.
3. 王庆贤.髋臼骨折生物力学研究进展.国外医学:骨科学分册,2001,22(4):217-220.
4. Letournel E,Judet R.Fractures of the Acetabulum.2nd eds.Berlin:Springer-Verlag,1993:77-85.
5. Pennal G,Davidson J,Garside H,et al.Results of treatment of acetabular fractures.Clin Orthop Relat Res,1980,(151):115-123.
6. Olson SA,Bay BK,Hamel A.Biomechanics of the hip joint and the effects of fracture of the acetabulum.Clin Orthop Relat Res,1997,(339):92-104.
7. Shazar N,Brumback RJ,Novak VP,et al.Biomechanical evaluation of transverse acetabular fracture fixation.Clin Orthop Relat Res,1998,(352):215-222.
8. 宋朝晖,张英泽,潘进社,等.髋臼后壁骨折对髋臼与股骨头之间应力的影响.中华创伤杂志,2002,18(2):91-93.
9. 黄庆森,单文钵,尚天裕,等.骨骼系统基本生物力学.天津:天津科学技术出版社,1983:164.
10. Olson SA,Bay BK,Chapman MW,et al.Biomechanical consequences of fracture and repair of the posterior wall of the acetabulum.J Bone Joint Surg (Am),1995,77(8):1184-1192.
11. Baumgaertner MR.Fractures of the posterior wall of the acetabulum.J Am Acad Orthop Surg,1999,7(1):54-65.
12. Matta JM.Fractures of the acetabulum:accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury.J Bone Joint Surg (Am),1996,78(11):1632-1645.
13. Mitsionis GI,Lykissas MG,Motsis E,et al.Surgical management of posterior hip dislocations associated with posterior wall acetabular fracture:a study with a minimum follow-up of 15 years.J Orthop Trauma,2012,26(8):460-465.
14. 张春才,许硕贵,禹宝庆,等.髋臼粉碎性骨折合并压缩性缺损的治疗与对策.中华创伤骨科杂志,2005,7(11):1010-1014.

Chinese Journal of Reparative and Reconstructive Surgery

BIOMECHANICS STUDY ON ACETABULAR POSTERIOR WALL FRACTURE

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