Is Anterior Plating Superior to the Bilateral Use of Retrograde Transpubic Screws for Treatment of Straddle Pelvic Ring Fractures? A Biomechanical Investigation

Background: Fractures of the four anterior pubic rami are described as “straddle fractures”. The aim of this study was to compare biomechanical anterior plating (group 1) versus the bilateral use of retrograde transpubic screws (group 2). Methods: A straddle fracture was simulated in 16 artificial p...

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Autores principales:	Moritz F. Lodde, J. Christoph Katthagen, Clemens O. Schopper, Ivan Zderic, R. Geoff Richards, Boyko Gueorguiev, Michael J. Raschke, René Hartensuer
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	straddle fractures pelvic ring injury biomechanics anterior pelvic plating retrograde transpubic screw Medicine R
Acceso en línea:	https://doaj.org/article/7550888ee3c64c578c0feb6cead22146
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spelling	oai:doaj.org-article:7550888ee3c64c578c0feb6cead221462021-11-11T17:40:12ZIs Anterior Plating Superior to the Bilateral Use of Retrograde Transpubic Screws for Treatment of Straddle Pelvic Ring Fractures? A Biomechanical Investigation10.3390/jcm102150492077-0383https://doaj.org/article/7550888ee3c64c578c0feb6cead221462021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/5049https://doaj.org/toc/2077-0383Background: Fractures of the four anterior pubic rami are described as “straddle fractures”. The aim of this study was to compare biomechanical anterior plating (group 1) versus the bilateral use of retrograde transpubic screws (group 2). Methods: A straddle fracture was simulated in 16 artificial pelvises. All specimens were tested under progressively increasing cyclic loading, with monitoring by means of motion tracking. Results: Axial stiffness did not differ significantly between the groups, <i>p</i> = 0.88. Fracture displacement after 1000–4000 cycles was not significantly different between the groups, <i>p</i> ≥ 0.38; however, after 5000 cycles it was significantly less in the retrograde transpubic screw group compared to the anterior plating group, <i>p</i> = 0.04. No significantly different flexural rotations were detected between the groups, <i>p</i> ≥ 0.32. Moreover, no significant differences were detected between the groups with respect to their cycles to failure and failure loads, <i>p</i> = 0.14. Conclusion: The results of this biomechanical study reveal less fracture displacement in the retrograde transpubic screw group after long-term testing with no further significant difference between anterior plating and bilateral use of retrograde transpubic screws. While the open approach using anterior plating allows for better visualization of the fracture site and open reduction, the use of bilateral retrograde transpubic screws, splinting the fracture, presents a minimally invasive and biomechanically stable technique.Moritz F. LoddeJ. Christoph KatthagenClemens O. SchopperIvan ZdericR. Geoff RichardsBoyko GueorguievMichael J. RaschkeRené HartensuerMDPI AGarticlestraddle fracturespelvic ring injurybiomechanicsanterior pelvic platingretrograde transpubic screwMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5049, p 5049 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	straddle fractures pelvic ring injury biomechanics anterior pelvic plating retrograde transpubic screw Medicine R
spellingShingle	straddle fractures pelvic ring injury biomechanics anterior pelvic plating retrograde transpubic screw Medicine R Moritz F. Lodde J. Christoph Katthagen Clemens O. Schopper Ivan Zderic R. Geoff Richards Boyko Gueorguiev Michael J. Raschke René Hartensuer Is Anterior Plating Superior to the Bilateral Use of Retrograde Transpubic Screws for Treatment of Straddle Pelvic Ring Fractures? A Biomechanical Investigation
description	Background: Fractures of the four anterior pubic rami are described as “straddle fractures”. The aim of this study was to compare biomechanical anterior plating (group 1) versus the bilateral use of retrograde transpubic screws (group 2). Methods: A straddle fracture was simulated in 16 artificial pelvises. All specimens were tested under progressively increasing cyclic loading, with monitoring by means of motion tracking. Results: Axial stiffness did not differ significantly between the groups, <i>p</i> = 0.88. Fracture displacement after 1000–4000 cycles was not significantly different between the groups, <i>p</i> ≥ 0.38; however, after 5000 cycles it was significantly less in the retrograde transpubic screw group compared to the anterior plating group, <i>p</i> = 0.04. No significantly different flexural rotations were detected between the groups, <i>p</i> ≥ 0.32. Moreover, no significant differences were detected between the groups with respect to their cycles to failure and failure loads, <i>p</i> = 0.14. Conclusion: The results of this biomechanical study reveal less fracture displacement in the retrograde transpubic screw group after long-term testing with no further significant difference between anterior plating and bilateral use of retrograde transpubic screws. While the open approach using anterior plating allows for better visualization of the fracture site and open reduction, the use of bilateral retrograde transpubic screws, splinting the fracture, presents a minimally invasive and biomechanically stable technique.
format	article
author	Moritz F. Lodde J. Christoph Katthagen Clemens O. Schopper Ivan Zderic R. Geoff Richards Boyko Gueorguiev Michael J. Raschke René Hartensuer
author_facet	Moritz F. Lodde J. Christoph Katthagen Clemens O. Schopper Ivan Zderic R. Geoff Richards Boyko Gueorguiev Michael J. Raschke René Hartensuer
author_sort	Moritz F. Lodde
title	Is Anterior Plating Superior to the Bilateral Use of Retrograde Transpubic Screws for Treatment of Straddle Pelvic Ring Fractures? A Biomechanical Investigation
title_short	Is Anterior Plating Superior to the Bilateral Use of Retrograde Transpubic Screws for Treatment of Straddle Pelvic Ring Fractures? A Biomechanical Investigation
title_full	Is Anterior Plating Superior to the Bilateral Use of Retrograde Transpubic Screws for Treatment of Straddle Pelvic Ring Fractures? A Biomechanical Investigation
title_fullStr	Is Anterior Plating Superior to the Bilateral Use of Retrograde Transpubic Screws for Treatment of Straddle Pelvic Ring Fractures? A Biomechanical Investigation
title_full_unstemmed	Is Anterior Plating Superior to the Bilateral Use of Retrograde Transpubic Screws for Treatment of Straddle Pelvic Ring Fractures? A Biomechanical Investigation
title_sort	is anterior plating superior to the bilateral use of retrograde transpubic screws for treatment of straddle pelvic ring fractures? a biomechanical investigation
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/7550888ee3c64c578c0feb6cead22146
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Is Anterior Plating Superior to the Bilateral Use of Retrograde Transpubic Screws for Treatment of Straddle Pelvic Ring Fractures? A Biomechanical Investigation

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