Abstract
Purpose
We evaluated the biomechanical characteristics of the transiliac internal fixator (TIFI) as compared to two well-established methods of internal posterior pelvic ring fixation.
Methods
Six freshly frozen human pelves were used for simulated single-leg stance loading of an AO type C injury model (pubic symphysis diastasis and unilateral sacroiliac joint disruption). The symphysis rupture was stabilized with a dynamic compression plate. Afterwards the three internal stabilization systems (TIFI, iliosacral screws and ventral plate osteosynthesis) were analysed. Fragment movement was measured in a contact-free manner with a stereophotometric infrared system.
Results
No significant differences in the three-dimensional deformation tolerated by the TIFI as compared to the other internal fixation systems were found.
Conclusions
The transiliac internal fixator provides the same biomechanical stability as the other reference implants tested. We suggest the use of this device as a suitable alternative to the other implants.
Similar content being viewed by others
References
Tile M (1988) Pelvic ring fractures: should they be fixed? J Bone Joint Surg Br 70(1):1–12
Culemann U, Tosounidis G, Reilmann H, Pohlemann T (2004) Injury to the pelvic ring. Diagnosis and current possibilities for treatment. Unfallchirurg 107(12):1169–1181, quiz 1182–1163
Pape HC, Giannoudis PV, Krettek C, Trentz O (2005) Timing of fixation of major fractures in blunt polytrauma: role of conventional indicators in clinical decision making. J Orthop Trauma 19(8):551–562
Giannoudis PV, Pape HC (2004) Damage control orthopaedics in unstable pelvic ring injuries. Injury 35(7):671–677
Nerlich M, Maghsudi M (1996) Algorithms for early management of pelvic fractures. Injury 27(Suppl 1):S-A29–S-A37
Pohlemann T, Tscherne H, Baumgartel F, Egbers HJ, Euler E, Maurer F, Fell M, Mayr E, Quirini WW, Schlickewei W, Weinberg A (1996) Pelvic fractures: epidemiology, therapy and long-term outcome. Overview of the multicenter study of the Pelvis Study Group. Unfallchirurg 99(3):160–167
Connor GS, McGwin G Jr, MacLennan PA, Alonso JE, Rue LW 3rd (2003) Early versus delayed fixation of pelvic ring fractures. Am Surg 69(12):1019–1023, discussion 1023–1014
Pohlemann T, Culemann U, Gansslen A, Tscherne H (1996) Severe pelvic injury with pelvic mass hemorrhage: determining severity of hemorrhage and clinical experience with emergency stabilization. Unfallchirurg 99(10):734–743
Thannheimer A, Woltmann A, Vastmans J, Buhren V (2004) The unstable patient with pelvic fracture. Zentralbl Chir 129(1):37–42
Bottlang M, Simpson T, Sigg J, Krieg JC, Madey SM, Long WB (2002) Noninvasive reduction of open-book pelvic fractures by circumferential compression. J Orthop Trauma 16(6):367–373
Simpson LA, Waddell JP, Leighton RK, Kellam JF, Tile M (1987) Anterior approach and stabilization of the disrupted sacroiliac joint. J Trauma 27(12):1332–1339
Lehmann J (1934) Luxation einer Beckenhälfte. Zentralbl Chir 37:2149–2152
Vanderschot P, Meuleman C, Lefevre A, Broos P (2001) Trans iliac-sacral-iliac bar stabilisation to treat bilateral lesions of the sacro-iliac joint or sacrum: anatomical considerations and clinical experience. Injury 32(7):587–592
Yinger K, Scalise J, Olson SA, Bay BK, Finkemeier CG (2003) Biomechanical comparison of posterior pelvic ring fixation. J Orthop Trauma 17(7):481–487
Kabak S, Halici M, Tuncel M, Avsarogullari L, Baktir A, Basturk M (2003) Functional outcome of open reduction and internal fixation for completely unstable pelvic ring fractures (type C): a report of 40 cases. J Orthop Trauma 17(8):555–562
Fuechtmeier B, Maghsudi M, Neumann C, Hente R, Roll C, Nerlich M (2004) The minimally invasive stabilization of the dorsal pelvic ring with the transiliacal internal fixator (TIFI)–surgical technique and first clinical findings. Unfallchirurg 107(12):1142–1151
van Zwienen CM, van den Bosch EW, Snijders CJ, Kleinrensink GJ, van Vugt AB (2004) Biomechanical comparison of sacroiliac screw techniques for unstable pelvic ring fractures. J Orthop Trauma 18(9):589–595
Saiki K, Hirabayashi S, Horie T, Tsuzuki N, Inokuchi K, Tsutsumi H (2002) Anatomically correct reduction and fixation of a Tile C-1 type unilateral sacroiliac disruption using a rod and pedicle screw system between the S1 vertebra and the ilium: experimental and clinical case report. J Orthop Sci 7(5):581–586
Mucha P Jr, Farnell MB (1984) Analysis of pelvic fracture management. J Trauma 24(5):379–386
Ragnarsson B, Olerud C, Olerud S (1993) Anterior square-plate fixation of sacroiliac disruption. 2–8 years follow-up of 23 consecutive cases. Acta Orthop Scand 64(2):138–142
Kellam JF, McMurtry RY, Paley D, Tile M (1987) The unstable pelvic fracture operative treatment. Orthop Clin North Am 18(1):25–41
Giannoudis PV, Tzioupis CC, Pape HC, Roberts CS (2007) Percutaneous fixation of the pelvic ring: an update. J Bone Joint Surg Br 89(2):145–154
Hao T, Changwei Y, Qiulin Z (2009) Treatment of posterior pelvic ring injuries with minimally invasive percutaneous plate osteosynthesis. Int Orthop 33(5):1435–1439
Linde F, Sorensen HC (1993) The effect of different storage methods on the mechanical properties of trabecular bone. J Biomech 26(10):1249–1252
Panjabi MM, Krag M, Summers D, Videman T (1985) Biomechanical time-tolerance of fresh cadaveric human spine specimens. J Orthop Res 3(3):292–300
Shaw JA, Mino DE, Werner FW, Murray DG (1985) Posterior stabilization of pelvic fractures by use of threaded compression rods. Case reports and mechanical testing. Clin Orthop Relat Res 192:240–254
Ponsen KJ, Hoek van Dijke GA, Joosse P, Snijders CJ (2003) External fixators for pelvic fractures: comparison of the stiffness of current systems. Acta Orthop Scand 74(2):165–171
Tornetta P 3rd, Matta JM (1996) Outcome of operatively treated unstable posterior pelvic ring disruptions. Clin Orthop Relat Res 329:186–193
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Dienstknecht, T., Berner, A., Lenich, A. et al. Biomechanical analysis of a transiliac internal fixator. International Orthopaedics (SICOT) 35, 1863–1868 (2011). https://doi.org/10.1007/s00264-011-1251-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00264-011-1251-5