title: Biomechanical study of four kinds of percutaneous screw fixation  in two types of unilateral sacroiliac joint dislocation: a finite  element analysis.
abstract: OBJECTIVE
  To compare the biomechanical stability of four different kinds of percutaneous screw fixation in two types of unilateral sacroiliac joint dislocation.
  
  
  METHODS
  Finite element models of unstable Tile type B and type C pelvic ring injuries were created in this study. Modelling was based on fixation with a single S1 screw (S1-1), single S2 screw (S2-1), two S1 screws (S1-2) and a combination of a single S1 and a single S2 screw (S1–S2). The biomechanical test of two types of pelvic instability (rotational or vertical) with four types of percutaneous fixation were compared. Displacement, flexion and lateral bend (in bilateral stance) were recorded and analyzed.
  
  
  RESULTS
  Maximal inferior translation (displacement) was found in the S2-1 group in type B and C dislocations which were 1.58 mm and 1.90 mm, respectively. Maximal flexion was found in the S2-1 group in type B and C dislocations which were 1.55° and 1.95°, respectively. The results show that the flexion from most significant angulation to least is S2-1, S1-1, S1-2, and S1–S2 in type B and C dislocations. All the fixations have minimal lateral bend.
  
  
  CONCLUSIONS
  Our findings suggest single screw S1 fixation should be adequate fixation for a type B dislocation. For type C dislocations, one might consider a two screw construct (S1–S2) to give added biomechanical stability if clinically indicated.
authors.forename: Lihai
authors.initials: L
authors.lastname: Zhang
authors.forename: Ye
authors.initials: Y
authors.lastname: Peng
authors.forename: Chengfei
authors.initials: C
authors.lastname: Du
authors.forename: Peifu
authors.initials: P
authors.lastname: Tang
mesh_terms: D001696:Biomechanical Phenomena; D001863:Bone Screws; D020342:Finite Element Analysis; D005593:Fracture Fixation, Internal / Q000193:education / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D004204:Joint Dislocations / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D012446:Sacroiliac Joint / Q000503:physiopathology / Q000601:surgery*; D013314:Stress, Mechanical; D013718:Tensile Strength