Biomechanical comparison of five iliosacral screw fixation techniques for Tile C1.3 pelvic fracture under two-legged standing load: a cadaver study

Abstract

Abstract There lack biomechanical studies of different Iliosacral screw (ISS) techniques in treating Tile C1.3 pelvic fracture. This study aimed to evaluate the biomechanical effects of five ISS techniques at two angles of sacral slope (SS). Six cadaveric Tile C1.3 pelvic fracture specimens were subjected to 500 N compressive force in two-leg stance at 30° and 40° SS. They were fixed randomly with S1 ISS, S1 trans-iliac-trans-sacral screw (TITSS), S2 TITSS, S1 ISS + S2 TITSS, and S1 TITSS + S2 TITSS. Displacement and rotation were measured and analyzed. The S1 TITSS reduced the total, lateral and vertical displacement compared with the S1 ISS, and provided more vertical stability than the S2 TITSS. The S1 TITSS + S2 TITSS ensured more vertical stability than the S1 ISS + S2 TITSS, whereas it did not improve the pelvic stability compared to the single S1 TITSS. The S1 ISS + S2 TITSS enhanced total, lateral and vertical stability compared to single S1 ISS. The vertical displacement at 40° SS tended to be greater than that at 30° SS. This study demonstrated biomechanical advantages of different ISS and potential effect of SS on pelvic stability, which may help making ideal clinical choices.