Biomechanical analysis of the acetabular buttress-plate: are complex acetabular fractures in the quadrilateral area stable after treatment with anterior construct plate-1/3 tube buttress plate fixation?

Clinics (Sao Paulo). 2013 Jul;68(7):1028-33. doi: 10.6061/clinics/2013(07)22.

Abstract

Objective: The acetabular buttress-plate has been widely used in treating difficult cases with satisfying clinical results. However, the biomechanical properties of a postoperative acetabular fracture fixed by the buttress-plate are not clear. The purpose of this study was to evaluate the biomechanical properties of stability after the anterior tube buttress-plate fixation of complex acetabular fractures in the quadrilateral area.

Methods: A construct was proposed based on anterior construct plate - 1/3 tube buttress plate fixation for acetabular both-column fractures. Two groups of six formalin-preserved cadaveric pelvises were analyzed: (1) group A, the normal pelvis and (2) group B, anterior construct plate-1/3 tube buttress plate with quadrilateral area fixation. The displacements were measured, and cyclical loads were applied in both standing and sitting simulations.

Results: As the load was added, the displacements were A<B, increasing in line. In the 600 N physiological loading, the differences were significant (standing position: p=0.013; sitting position: p=0.009) between groups A and B.

Conclusion: The anterior construct plate - 1/3 tube buttress plate fixation provided a better stable construct for early sitting. The standing mode yielded more significant differences between the groups. Placing a 1/3 tube buttress-plate via an anterior approach is a novel method of providing quadrilateral area support in this setting.

MeSH terms

  • Acetabulum / injuries*
  • Analysis of Variance
  • Biomechanical Phenomena
  • Bone Plates*
  • Fracture Fixation, Internal / methods*
  • Fractures, Bone / surgery*
  • Humans
  • Joint Dislocations
  • Reference Values
  • Reproducibility of Results