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Abstract
Neither plating nor lag screw fixation of a displaced iliac wing fracture as part
of an unstable pelvic ring disruption has been studied biomechanically. The purpose
of this study was to compare the stability of various combinations of fixation, specifically
contrasting lag screws placed between the tables of the ilium with plating in different
locations across the fracture line. Various combinations of these fixation implants
were evaluated for an unstable iliac fracture. A longitudinal iliac fracture was created
in each of six hemi-pelvic specimens prior to testing. Compressive force, up to 500
N or to the magnitude necessary to displace the fracture 2mm, was applied to the fracture
line through the hemi-pelvis for each of the plate and lag screw combinations tested.
There was no statistical difference between any of the implants or combinations tested.
A single 3.5-mm reconstruction (cephalad) plate placed along the cephalad internal
aspect of the iliac crest provided the least stability allowing 2 mm of displacement
with a mean load of 80N. The two combinations of fixation that required the greatest
loads for 2 mm of displacement were a single 3.5-mm lag (cephalad) screw inserted
into the iliac crest between the tables of the ilium coupled with either a 3.5-mm
reconstruction (brim) plate placed along the internal aspect of the inferior iliac
fossa at the pelvic brim (239 N) or a 4.5-mm lag (brim) screw between the inner and
outer tables at the inferior aspect of the fracture just above the greater sciatic
nothch (225 N).
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Article info
Publication history
Accepted:
June 25,
1997
Identification
Copyright
© 1997 Published by Elsevier Inc.