Article

Pelvic ring fractures are severe injuries whose functional results
depend on the quality of reduction. Numerous internal fixation alternatives have
been described, but the biomechanical studies comparing them remain rare.
This study compared the biomechanical behavior of iliosacral screws
(ISS) with sacroiliac hinge type fixation (SIF) following unstable pelvic ring
fractures fixation. METHODS: A lesion simulating sacroiliac
disruption and pubic disruption was created on 14 cadaver pelves. After
randomization, the fractures were internally fixed using an anterior plate
associated with either an ISS or an SIF. The specimens were then submitted to
forces applied vertically at the coxofemoral joints. Relative movements in
vertical translation and in rotation between the iliac wing and the sacrum, as
well as the stiffness and the forces at failure of the assemblies were measured
and compared. RESULTS: The mean age of the bodies was 66 years (+/-8). No
significant difference was demonstrated between the groups in terms of residual
motion and stiffness in both vertical and rotational displacement. The results
showed a slight residual mobility in rotation of the hemipelvis. The SIFs
presented greater, although non significant resistance to failure. No fixation,
however, restituted stiffness comparable to a healthy pelvis. DISCUSSION: The
results of this study show that a Tile C.1.2-type injury to the pelvic ring can
be treated as effectively with ISS or SIF when combined anterior and posterior
fixations are performed. SIF therefore seems reliable and its continued use is
justified. The long-term clinical outcomes should nevertheless be evaluated,
notably on the younger population, more often affected by this type of injury.

Langue : FRANCAIS