PhD Scientific Days 2023

Clinical Medicine III.

Patient-Specific Bone Modeling Can Better Predict Biomechanical Outcomes of Sacral Fracture Fixations

Előadó neve

Mate, Turbucz

Neptun code

RMB8D9

Előadó munkahelye

National Center for Spinal Disorders

Előadó telefonszáma

06306866662

Előadó e-mail címe

turbucz95@gmail.com

Az előadás címe

Patient-Specific Bone Modeling Can Better Predict Biomechanical Outcomes of Sacral Fracture Fixations

Szerző(k) neve és munkahelye

Mate Turbucz1,2, Agoston Pokorni1,2, Aron Lazary2,3, Peter Eltes2,3

1 School of PhD Studies, Semmelweis University, Budapest
2 In Silico Biomechanics Laboratory, National Center for Spinal Disorders, Buda Health Center, Budapest
3 Department of Spine Surgery, Department of Orthopaedics, Semmelweis University, Budapest

Bemutatás módja

Szóbeli

Szekció

Clinical Medicine III.

Language of the presentation

Hungarian

Preferred session

Clinical Medicine

Összefoglaló szövege

Introduction:
Unilateral sacral fractures are relatively common injuries that can be challenging to manage. Various fixation techniques have been proposed to provide stable fixation, but their biomechanical characteristics have not been extensively studied.
Aims:
The current study aimed to evaluate the effect of the locally defined patient-specific bone quality by applying two different sets of bone material properties in six different fixation techniques used for treating Denis Type II unilateral sacral fractures.
Method:
Two FE models of the intact pelvis were constructed; the literature-based model (LBM) was developed with homogenous bone material properties taken from the literature, while the patient-specific model (PSM) was created with heterogenous bone material properties based on the quantitative CT scans. Unilateral transforaminal sacral fracture was modelled to assess six different fixation techniques: iliosacral screw (ISS) at S1 (ISS1), ISS at S2 (ISS2), ISS at S1 and S2 (ISS12), transverse iliosacral screw (TISS) at S1 (TISS1), TISS at S2 (TISS2), and TISS at S1 and S2 (TISS12). A 600 N vertical load with both acetabula fixed was applied to simulate a double leg stance. Vertical stiffness (VS) normalized with the intact condition, relative interfragmentary displacement (RID), and the von Mises stress values on the fracture interface were analyzed.
Results:
The lowest and highest normalized VS was given by ISS1 and TISS12 techniques for LBM and PSM, 137% and 149%, and 375% and 472%, respectively. The maximum RID values were between 0.10 mm and 0.47 mm for all fixation techniques in both models. The von Mises stress results on the fracture interface show a substantial difference between the two bone modeling techniques, as PSM gave significantly lower stress values for all fixation techniques than LBM. Regarding the maximum stress values, the LBM gave higher values by 255.1, 20.3, 156.4, 286.9, 41.1 and 171.1 % compared to PSM
Conclusion:
Based on the results, all techniques can provide clinically sufficient stability. TISS12 was superior to all other fixations from a biomechanical point of view. Patient-specific bone modelling revealed that sacral fracture fixations should prioritize the S1 level over the S2, although long-term clinical trials are recommended to confirm the findings of the study.
Funding:
This project (no. KDP-14-3/PALY-2021) was implemented with the support provided by the Ministry of Culture and Innovation of Hungary from the National Research, Development and Innovation Fund, financed under the KDP-2020 funding scheme. The financial support from the funding body is gratefully acknowledged.

University and Doctoral School

Semmelweis University, Károly Rácz Doctoral School of Clinical Medicine

Supervisor

Aron Lazary and Peter Eltes

Publication of my abstract

I do not give consent to the publication of my abstract on the website of the congress.

Kind

Szabad

Status

elfogadva

Accepted presentation method

szóbeli

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

6039

Start

10:00

End

10:15

Authors (legacy)

Mate Turbucz1,2, Agoston Pokorni1,2, Aron Lazary2,3, Peter Eltes2,3

1 School of PhD Studies, Semmelweis University, Budapest
2 In Silico Biomechanics Laboratory, National Center for Spinal Disorders, Buda Health Center, Budapest
3 Department of Spine Surgery, Department of Orthopaedics, Semmelweis University, Budapest