CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2020; 55(04): 497-503
DOI: 10.1055/s-0039-1697973
Artigos Originais
Trauma

Are Anterior Plates More Effective than Iliosacral Screws to Fix the Sacroiliac Joint? Biomechanical Study[*]

Article in several languages: português | English
Flavio Goldsztajn
1  Departamento de Ortopedia, Américas Medical City, Rio de Janeiro, RJ, Brasil
,
Jose Ricardo L. Mariolani
2  Laboratório de Biomateriais em Ortopedia, Escola de Ciências Médicas, Universidade de Campinas, Campinas, SP, Brasil
,
William Dias Belangero
2  Laboratório de Biomateriais em Ortopedia, Escola de Ciências Médicas, Universidade de Campinas, Campinas, SP, Brasil
3  Departamento de Ortopedia, Escola de Ciências Médicas, Universidade de Campinas, Campinas, SP, Brasil
› Author Affiliations

Abstract

Introduction Sacroiliac joint dislocations are caused by high energy trauma and commonly treated with the iliosacral screw fixation or the anterior plating of the sacroiliac joint (SIJ). However, there is a lack of consensus regarding which procedure is the most successful in treating sacroiliac joint dislocations. This aims to compare stiffness and maximum load of pelvises with sacroiliac joint dislocations treated with both procedures in a synthetic bone model.

Methods Synthetic pelvises were mounted and divided into 2 treatment groups (n = 5): a model with two orthogonal plates placed anteriorly to the SIJ (PPS group) and another with two iliosacral screws fixating the SIJ (SPS group), both with pubic symphysis fixation. The maximum load supported by each sample was observed and the stiffness was calculated from the curve load vs displacement. The mean values of load to failure and stiffness for each group were compared with the Mann-Whitney U test (p < 0.05 was considered significant for all analysis).

Results The mean load to failure supported by the PPS group was 940 ± 75 N and the SPS was 902 ± 56 N, with no statistical difference. The SPS group showed higher values of stiffness (68.6 ± 11.1 N/mm) with statistical significant difference in comparison to the PPS sample (50 ± 4.0 N/mm). The mode of failure was different in each group tested.

Conclusion Despite lower stiffness, the anterior plating fixation of the sacroiliac joint can be very useful when the iliosacral screw fixation cannot be performed. Further studies are necessary to observe any differences between these two procedures on the clinical and surgical setting.

* Work developed at the Laboratory of Biomaterials in Orthopedics, School of Medical Sciences, Universidade de Campinas, Campinas, SP, Brazil.




Publication History

Received: 22 February 2019

Accepted: 18 July 2019

Publication Date:
09 January 2020 (online)

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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