Posterior column acetabular fracture fixation using a W-shaped angular plate: A biomechanical analysis

• Published in: PloS one 2017-11, Vol.12 (11), p.e0187886-e0187886
• Main Authors: Su, Ke, Liu, Song, Wu, Tao, Yin, Yingchao, Zhang, Ruipeng, Li, Shilun, Zhang, Yingze
• Format: Article
• Language: English
• Subjects: Acetabulum; Acetabulum - diagnostic imaging; Acetabulum - physiopathology; Acetabulum - surgery; Arthritis; Arthritis - complications; Arthritis - physiopathology; Arthritis - surgery; Biology and Life Sciences; Biomechanical engineering; Biomechanical Phenomena; Biomechanics; Bone Density - physiology; Bone Screws; Cadavers; Feasibility studies; Femur - physiopathology; Femur - surgery; Fixation; Fracture Fixation, Internal - methods; Fractures; Fractures, Bone - diagnostic imaging; Fractures, Bone - physiopathology; Fractures, Bone - surgery; Gauges; Health aspects; Hip joint; Humans; Internal fixation in fractures; Measuring instruments; Mechanical properties; Medicine and Health Sciences; Pelvis - pathology; Pelvis - surgery; Physical Sciences; Plates; Reconstruction; Restoration; Stiffness; Strain distribution; Strain gauges; Surgery; Surgical techniques; Transplants & implants; Trauma
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0187886

The purpose of this study was to compare the stability and feasibility of four fixation constructs in a posterior column acetabular fracture: one reconstruction plate, one reconstruction plate and lag screw, two reconstruction plates, and a W-shaped acetabular angular plate. Twenty embalmed cadaveric pelvises with a posterior column acetabular fractures were allocated to one of four groups: 1) a reconstruction plate, 2) a reconstruction plate with a posterior column lag screw, 3) double reconstruction plates, and 4) a W-shaped acetabular angular plate. These constructs were mechanically loaded on a testing machine, and construct stiffness values were measured. Strain gauges were utilized to measure the mechanical behavior in the condition of compressive force. Final stiffness was not different between the two reconstruction plates (445.81±98.30 N/mm) and the W-shaped acetabular angular plate (447.43±98.45 N/mm, p = 0.524), both of which were superior to a single reconstruction plate (248.90±61.95 N/mm) and a combined plate and lag screw (326.41±94.34 N/mm). Following the fixation of the W-shaped acetabular angular plate, the strain distribution was similar to the intact condition around the acetabulum. The parameters of the W-shaped acetabular angular plate that were observed at the superior region of the acetabulum were less than those of a single reconstruction plate (p