Experimental study of fractures of the posterior pelvic ring C1.1 using LC-II screws and internal fixation by plate.

Abstract

Introduction: To compare the biomechanical outcomes of C1.1 posterior pelvic ring fractures treated with different numbers of LC-II screws and plate internal fixation.

Materials and methods: Nine adult preserved pelvic specimens were used. After being measured by bone densitometry, the specimens were randomly divided into 3 groups of 3 pelvic specimens each. The C1.1 pelvic fractures were generated by iliac osteotomies and anterior pelvic ring osteotomies. The fractures were fixed and randomly divided into three groups: (1) one LC-II screw, (2) two LC-II screws, and (3) two reconstruction plates. The anterior pelvic rings were all fixed with pubic branch screws. A biomechanical testing machine loaded all specimens vertically, recording the displacement and ultimate load of the specimens to quantify the stiffness.

Results: When loads up to 1000 N were applied, the displacement of the iliac bone was close between the one LC-II screw and the two LC-II screw group specimens; (P > 0.05); when loads such as 1000 N, 1200 N and 1400 N were applied, there was no significant difference in displacement between the plate fixation group and the two LC-II screw fixation group (P > 0.05), both of which were superior to the one LC-II screw fixation group (P < 0.05). There was no significant difference in compressive stiffness between the two LC-II screw fixation groups and the plate fixation group (P > 0.05), and both were superior to the one LC-II screw fixation group (P < 0.05) the ultimate load of both the two LC-II screws and the steel plate is greater than that of one LC-II screw (1.74 times the ultimate load of one LC-II screw for the two LC-II screws and 1.83 times the ultimate load of one LC-II screw for the steel plate).

Conclusion: For posterior pelvic ring fractures of type C1.1, placement of two LC-II screws provides comparable posterior pelvic ring stability compared to reconstructed plates. At loads below 1000 N, one LC-II screw fixation and two LC-II screws were comparable in restoring posterior pelvic ring stability.