Eric M Kiskaddon1, Amanda Wright2, Brett D Meeks3, Andrew W Froehle3, Greg C Gould4, Marc G Lubitz5, Michael J Prayson3, Brandon R Horne3. 1. Orthopaedic Surgery, Wright State University Department of Orthopaedic and Plastic Surgery, Dayton, OH, United States. Electronic address: erickiskaddon@gmail.com. 2. Andrews Institute, Orthopaedics and Sports Medicine, Gulf Breeze, FL, United States. 3. Orthopaedic Surgery, Wright State University Department of Orthopaedic and Plastic Surgery, Dayton, OH, United States. 4. Premier Health Partners, Miami Valley Hospital Biosciences Center, Dayton, OH, United States. 5. University of Massachusetts Department of Orthopedics and Physical Rehabilitation, North Worcester, MA, United States.
Abstract
OBJECTIVES: To determine whether suture button fixation of the pubic symphysis is biomechanically similar to plate fixation in the treatment of partially stable pelvic ring injuries. METHODS: Twelve pelvis specimens were harvested from fresh frozen cadavers. Dual-x-ray-absorptiometry (DXA) scans were obtained for all specimens. The pubic symphysis of each specimen was sectioned to simulate a partially stable pelvic ring injury. Six of the pelvises were instrumented using a 6 hole, 3.5 mm low profile pelvis plate and six of the pelvises were instrumented with two suture button devices. Biomechanical testing was performed on a pneumatic testing apparatus in a manner that simulates vertical stance. Displacement measurements of the superior, middle, and inferior pubic symphysis were obtained prior to loading, after an initial 440 N load, and after 30,000 and 60,000 rounds of cyclic loading. Statistical analysis was performed using Wilcoxon-Mann-Whitney tests, Fisher's exact test, and Cohen's d to calculate effect size. Significance was set at p < 0.05. RESULTS: There was no difference between groups for DXA T scores (p = 0.749). Between group differences in clinical load to failure (p = 0.65) and ultimate load to failure (p = 0.52) were not statistically significant. For symphysis displacement, the change in fixation strength and displacement with progressive cyclic loading was not significant when comparing fixation types (superior: p = 0.174; middle: p = 0.382; inferior: p = 0.120). CONCLUSION: Suture button fixation of the pubic symphysis is biomechanically similar to plate fixation in the management of partially stable pelvic ring injuries.
OBJECTIVES: To determine whether suture button fixation of the pubic symphysis is biomechanically similar to plate fixation in the treatment of partially stable pelvic ring injuries. METHODS: Twelve pelvis specimens were harvested from fresh frozen cadavers. Dual-x-ray-absorptiometry (DXA) scans were obtained for all specimens. The pubic symphysis of each specimen was sectioned to simulate a partially stable pelvic ring injury. Six of the pelvises were instrumented using a 6 hole, 3.5 mm low profile pelvis plate and six of the pelvises were instrumented with two suture button devices. Biomechanical testing was performed on a pneumatic testing apparatus in a manner that simulates vertical stance. Displacement measurements of the superior, middle, and inferior pubic symphysis were obtained prior to loading, after an initial 440 N load, and after 30,000 and 60,000 rounds of cyclic loading. Statistical analysis was performed using Wilcoxon-Mann-Whitney tests, Fisher's exact test, and Cohen's d to calculate effect size. Significance was set at p < 0.05. RESULTS: There was no difference between groups for DXA T scores (p = 0.749). Between group differences in clinical load to failure (p = 0.65) and ultimate load to failure (p = 0.52) were not statistically significant. For symphysis displacement, the change in fixation strength and displacement with progressive cyclic loading was not significant when comparing fixation types (superior: p = 0.174; middle: p = 0.382; inferior: p = 0.120). CONCLUSION: Suture button fixation of the pubic symphysis is biomechanically similar to plate fixation in the management of partially stable pelvic ring injuries.
Authors: Markus A Küper; Alexander Trulson; Jonas Johannink; Bernhard Hirt; Artur Leis; Max Hoßfeld; Tina Histing; Steven C Herath; Bastian Amend Journal: J Robot Surg Date: 2022-02-11
Authors: Adrian Cavalcanti Kußmaul; Fanny Schwaabe; Manuel Kistler; Maximilian Jörgens; Korbinian F Schreyer; Axel Greiner; Wolfgang Böcker; Christopher A Becker Journal: Arch Orthop Trauma Surg Date: 2022-07-13 Impact factor: 2.928
Authors: Adrian Cavalcanti Kußmaul; Fanny Schwaabe; Manuel Kistler; Clara Gennen; Sebastian Andreß; Christopher A Becker; Wolfgang Böcker; Axel Greiner Journal: Arch Orthop Trauma Surg Date: 2021-05-29 Impact factor: 2.928