Finite element analysis of sacral-alar-iliac screw fixation for sacroiliac joint dislocation

Zhang, Wei<sup>1,2,3,4,*</sup>; Cheng, Yucheng<sup>1,2,3,4,*</sup>; Diarra, Mohamed diaty<sup>1,2,3,4,*</sup>; Chen, Erman<sup>1,2,3,4</sup>; Hou, Weiduo<sup>1,2,3,4</sup>; Xin, Zengfeng<sup>1,2,3,4</sup>; Pan, Zhijun<sup>1,2,3,4</sup>; Li, Weixu<sup>1,2,3,4</sup>

Affiliations

¹Department of Orthopedics, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China

²Research Institute of Orthopedics, Zhejiang University, Hangzhou, China

³Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou City, Zhejiang Province, PR China

⁴Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou, Zhejiang Province, PR China

Abstract and keywords

The percutaneous sacroiliac (SI) screw is a common fixation option for posterior ring disruption in pelvic fractures. However, SI screw placement is difficult and can injure adjacent neurovascular structures. The sacral-alar-iliac screw (SAI) is a safe, reliable free-hand sacral pelvic fixation technique. To investigate the biomechanical stability of SAI for SI joint dislocation, finite element analysis was performed in unstable Tile-Type B and C pelvic ring injuries. The displacement in S1 (fixation of a unilateral S1 segment with one SI screw), TS1 (fixation of the S1 segment with a transsacra 1 screw), TS2 (fixation of the S2 segment with a transsacra 2 screw), S1AI, and S2AI exceeded the normal SI joint mobility. Sufficient stability after SI joint dislocation was obtained with (TS1 + TS2), (TS2 + S1), (S1AI + S2AI + rod), (S1AI + S2AI), and (S1 + S2AI + S1 pedicle) fixation. The TS1 + TS2 group had the smallest displacement and lowest peak screw stress, followed by (S1 + S2AI + S1 pedicle) placement. Our findings suggest that SAI screws are a valuable option for SI joint dislocation.

Keywords: finite element analysis; sacroiliac screw; sacroiliac joint dislocation; sacrum-alar-iliac screw

Links

DOI: 10.1002/jor.25525

PubMed: 36691867

WoS: 000919802600001

History

Received: 2022-10-05

Revised: 2023-01-08

Accepted: 2023-01-19

Cited Works (1)

Year	Entry
1995	Dalstra M, Huiskes R, van Erning L. Development and validation of a three-dimensional finite element model of the pelvic bone. J Biomech Eng. August 1995;117(3):272-278.