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Minimally invasive stabilization of posterior pelvic ring injuries with a transiliac internal fixator and two iliosacral screws: comparison of outcome and biomechanics
Salášek, Martin ; Pavelka, Tomáš (advisor) ; Džupa, Valér (referee) ; Plánka, Ladislav (referee)
Introduction: Vertically unstable sacral transforaminal fractures can be stabilized both with a transiliac internal fixator (TIFI) or iliosacral screws (IS). Goals: 1. comparison of radiological and clinical results between dorsal pelvic segment stabilization with TIFI, IS respectively, 2. evaluation and comparison of biomechanical parameters of TIFI and IS construct. Material and methods of clinical study: Prospective study, both TIFI and IS group had 32 patients, the most of injuries were assessed as type C1.3, only patients with a high-energy mechanism of injury were included. Radiological results were evaluated according Matta, clinical results according Majeed score, Pelvic Outcome Score. Categorical data were evaluated by two-sided Fishers exact test or Pearson's χ2 test, continuous data by Student's t-test, a test result with p <0.05 was considered as statistically significant. Methods of biomechanical study: Using CT images, finite element model of the pelvis was developed. Pohlemann type II fracture was simulated and fixed either with TIFI or two IS. The sacral base was loaded vertically (250-500 N), displacement magnitudes on medial and lateral fracture surface and the maximum bone stress were calculated. The intact pelvis was used as a reference. Stiffness was determined by linear...

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