Endoscopic treatment of injuries of the anterior pelvic ring: biomechanical comparison of five different endoscopic stabilization techniques
Final Report Abstract
High-energy trauma can lead to severe pelvic injuries known as "open book injuries," characterized by the rupture of the symphysis pubis and potentially involving the iliosacral joint. Traditionally, metal plates have been used to stabilize these injuries. While effective, metal plates can be overly rigid, leading to issues like loosening and breakage over time. Recently, alternative methods for fixation have been proposed, using suture buttons combined with fibretapes or anchors with fibretapes. These new methods aim to provide adequate stabilization while also offering increased flexibility and better compatibility with the body's natural movements. A biomechanical model was used to evaluate these alternative fixation methods through a series of static and cyclic tests to simulate two-legged standing and to simulate six weeks of walking, evaluating durability under repetitive loading. Finally, a failure measurement was conducted until osteosynthesis failure, determining the maximum load the fixation method could withstand. The results indicated that the alternative fixation methods using suture buttons and fibretapes, or anchors and fibretapes, were less stable than the traditional plate method. However, they offered significant advantages. The alternative methods provided a fixation closer to the natural physiological stance, which could be particularly beneficial for athletes and younger women. These groups may benefit from the greater flexibility and less rigid support, potentially leading to better long-term outcomes in terms of mobility and comfort. Despite being less stable initially, the load to failure for these alternative methods was found to be negligible, indicating that they could still provide adequate support under normal conditions and daily activities. In conclusion, while the traditional plate method remains the gold standard due to its superior stability, the alternative methods show promise for specific patient groups who may benefit from a fixation method that allows for more natural movement and flexibility. Further research and clinical trials are necessary to fully assess the long-term benefits and potential applications of these alternative fixation methods.
