Biomechanical analysis of fixation methods in acetabular fractures : a systematic review of test setups

Enthalten in
European journal of trauma and emergency surgery 
Volume
48
Issue
5
Start Page
3541
End Page
3560
Citation
European Journal of Trauma and Emergency Surgery 48 (5): 3541-3560 (2022)
Publisher DOI
10.1007/s00068-022-01936-9
Scopus ID
2-s2.0-85126472147
PubMed ID
35305114
Publisher
Springer Medizin
Peer Reviewed
true
Purpose: Optimal anatomical reduction and stable fixation of acetabular fractures are important in avoiding secondary dislocation and osteoarthritis. Biomechanical studies of treatment options of acetabular fractures aim to evaluate the biomechanical properties of different fixation methods. As the setup of the biomechanical test can influence the experimental results, this review aimed to analyze the characteristics, comparability and clinical implications of studies on biomechanical test setups and finite element analyses in the fixation of acetabular fractures. Methods: A systematic literature research was conducted according to the PRISMA guidelines, using the PubMed/MEDLINE and Web of Science databases. 44 studies conducting biomechanical analyses of fixation of acetabular fractures were identified, which met the predefined inclusion and exclusion criteria and which were published in English between 2000 and April 16, 2021. The studies were analyzed with respect to distinct parameters, including fracture type, material of pelvis model, investigated fixation construct, loading direction, loading protocol, maximum loading force, outcome parameter and measurement method. Results: In summary, there was no standardized test setup within the studies on fixation constructs for acetabular fractures. It is therefore difficult to compare the studies directly, as they employ a variety of different test parameters. Furthermore, the clinical implications of the biomechanical studies should be scrutinized, since several test parameters were not based on observations of the human physiology. Conclusion: The limited comparability and restricted clinical implications should be kept in mind when interpreting the results of biomechanical studies and when designing test setups to evaluate fixation methods for acetabular fractures.
Schlagworte
Acetabular fracture
Biomechanical analysis
Clinical implications
Finite element analysis
Fracture fixation
Inter-comparability
DDC Class
570: Biowissenschaften, Biologie
610: Medizin