A new combined reduction anatomical plate for the treatment of acetabular anterior column and posterior hemi-transverse fractures: a finite element analysis study

A new combined reduction anatomical plate for the treatment of acetabular anterior column and posterior hemi-transverse fractures: a finite element analysis study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A new combined reduction anatomical plate for the treatment of acetabular anterior column and posterior hemi-transverse fractures: a finite element analysis study Lin Chen, Chongshuai Bao, Ao Jun, Ansu Wang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4964573/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Acetabularanterior column and posterior hemi-transverse fractures pose a significant challenge for orthopaedic surgeons. Traditional treatment methods are associated with high rates of post-operative complications and lengthy surgical procedures. To enhance treatment efficacy, this study developed a novel internal fixation device called the Combined Reduction Anatomical Plate (CRAP) and conducted a finite element analysis to compare its biomechanical properties to those of traditional internal fixation methods. Methods: A standard finite element model of an anterior column and posterior hemi-transverse fracture of the acetabulum was established using finite element software. Subsequently, four different internal fixation devices were applied: CRAP, double-column locking plates (DLP), supra-pectineal quadrilateral anatomical plate (SQAP), and iliositus + anterior column plate (LACP). After determining the boundary conditions and material properties, the model was simulated in three different body positions (standing, sitting, and lying on the affected side) and subjected to vertical downward forces of 200 N, 400 N, and 600 N. Subsequently, the stress distribution and peak values among the four fixation methods were analyzed, and the maximum pelvic displacement and fracture fragment displacement were evaluated. Results: In this study, the CRAP maximum stress on the steel plate and screws was 159.540 N, 160.540 N, 157.050 N, 177.330 N, 64.756 N, and 30.003 N, which was less than that of the SQAP and LACP and greater than that of the DLP. The maximum tangential micromotion of the CRAP was only 0.016 mm, and the maximum displacement of the pelvis was 0.855 mm. The results showed that the new type of plate developed and designed in this study exhibited a relatively uniform stress distribution and high stiffness, providing sufficient strength. However, the four groups showed no obvious difference in tangential fretting. Conclusion: Compared with the other three fixation methods, the newly designed sectional anatomical reduction plate and screws showed a uniform stress distribution, greater rigidity, sufficient strength, and improved mechanical stability. The CRAP can therefore provide sufficient biomechanical stability and help fracture healing. combined reduction anatomical plate acetabular fractures finite element analysis internal fixation Biomechanics Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 Figure 11 Figure 12 Figure 13 Figure 14 1 Introduction Acetabular fractures, intricate fractures occurring within the joint, are primarily the result of high-impact trauma. Recently, their frequency has risen due to a higher occurrence of traffic and industrial accidents [ 1 ] . To maximize the restoration of hip joint function, improve prognosis, and reduce the occurrence of complications, the preferred method for treating displaced acetabular fractures is now open reduction and internal fixation [ 2 , 3 ] . According to the Judet-Letournel [ 4 ] classification system, quadrilateral plate fractures are not classified separately, except for simple anterior and posterior wall fractures; still, 80% of the other fracture types may involve the quadrilateral plate [ 5 – 7 ] . This is particularly true in elderly patients, who often have osteoporosis and comminuted fractures [ 5 , 8 ] . Anterior column-posterior hemi-transverse fractures (ACPHTFs) are a common type of acetabular fracture, often accompanied by femoral head protrusion and quadrilateral plate displacement [ 9 – 11 ] . This fracture impacts both the anterior and posterior columns and involves the quadrilateral plate. Presently, it is considered that only anatomical reduction, which restores the smoothness and flatness of the hip joint, preserves the blood supply to the femoral head and intra-articular fractures, provides stable internal fixation, and can achieve good clinical outcomes [ 12 ] . However, due to the deep location of the quadrilateral plate, limited surgical space, difficulty in intra-operative exposure, and issues with traditional pelvic plates, such as difficulty in shaping during surgery, poor fit with pelvic anatomical structures, single fixation points, inadequate reduction, fixation of quadrilateral plate fractures, and screws easily entering the hip joint, leading to femoral head necrosis and traumatic arthritis [ 6 , 13 , 14 ] , these traditional methods no longer meet the requirements for precise reduction and strong fixation of this type of fracture. Therefore, we designed a specially shaped reconstruction plate (the Combined Reduction Anatomical Plate, CRAP) based on the anatomical characteristics of the acetabulum, which has been granted a Chinese national patent (Patent No.: CN202222137846.2). This fixation system includes two components: a locking plate and a reduction plate. The locking plate is a curved strip designed to fit above the greater sciatic notch, while the reduction plate is contoured to align with the anatomical structures above the acetabulum and the quadrilateral plate. This system is primarily used for treating acetabular fractures that involve the quadrilateral plate, such as posterior column fractures, T-type fractures, ACPHT, and both-column fractures. Considering the extremely irregular shape of the pelvis and the difficulty in shaping plates during surgery, we previously conducted an anatomical study on the CRAP fixation trajectory using computer-aided anatomical measurements. This study led to the design of anatomical plates and reduced the difficulty of shaping traditional plates during surgery [ 15 ] . However, comparative studies on the biomechanical properties of the newly designed CRAP and traditional plates have not been conducted, particularly regarding the biomechanical mechanisms during bone healing. Therefore, this study aimed to use the finite element method to compare the biomechanical properties and stability differences of four internal fixation methods for treating anterior column-posterior hemi-transverse fractures: combined reduction anatomical plate (CRAP), anterior column-posterior column plate (DLP), supra-pectineal quadrilateral plate (SQAP), and ilio-ischial-anterior column plate (LACP). This research offers a theoretical foundation for the expanded clinical use of the CRAP. 2 Materials and Methods 2.1 Establishment of the three-dimensional Finite Element Model for Anterior Column-Posterior Hemi-transverse Fractures A healthy 23-year-old male volunteer provided informed consent. Pelvic radiography excluded fractures, deformities, tumors, and other pathologies. This research received approval from our hospital's Medical Ethics Committee (ethics no. KLLY-2022-017). The DICOM data from the volunteers were imported into Mimics software (version 21.0, Materialise Company, Leuven, Belgium). The hemi-pelvic model was reconstructed and exported in STL format, followed by software construction of a standard finite element model (Fig. 1 a). The ACPHTF model was established according to the Judet and Letournel classification of acetabular fractures [ 16 , 17 ] . ACPHTFs primarily have two fracture lines: one extends from the anterior superior iliac spine to the inferior edge of the obturator foramen. The other extends from the midpoint of the first fracture line to the uppermost end of the sciatic notch (Fig. 1 b) [ 18 ] . 2.2 Modelling of Four Internal Fixation Models for Anterior Column-Posterior Hemi-transverse Fractures In this study, four internal fixation models (CRAP, DLP, SQP, and LCAP) were accurately constructed using SolidWorks 2017 software (SolidWorks Corporation, Dassault, France) based on the actual dimensions and shapes of the fixation devices. During the construction process, special attention was paid to the design characteristics of each fixation device, such as shape, size, and intended biomechanical application, to ensure model realism and functionality. After construction, these models were precisely assembled onto the ACPHTF model for subsequent finite element analysis (Fig. 2 ). 2.3 Definition of Boundary Conditions, Material Properties, and Loads The analysis was conducted using the ANSYS Workbench 2022 R1 (Ansys, Canonsburg, PA) software to generate standardized finite element models. 2.3.1 Boundary Conditions In the model, the contact between the bone surface and the internal fixation devices or between the internal fixation devices themselves was set as bonded contact. The contact between fracture fragments and cartilage was set as frictional contact with a friction coefficient of 0.2 to simulate physiological conditions. 2.3.2 Material Properties To construct the model, we assumed that all cortical bones, cancellous bones, plates, and screws were homogeneous and isotropic. To make the finite element model closer to physiological conditions, acetabular cartilage was included, and the ligaments were defined based on their anatomical locations. The standard finite element model defined the iliofemoral, ischiofemoral, pubofemoral, inferior iliofemoral, and superior iliofemoral ligaments. The material properties of the cortical bone, cancellous bone, articular cartilage, and ligaments were determined based on previous literature [ 19 – 23 ] . The material properties are listed in Tables 1 and 2 . Table 1 The composition of the various parts of the pelvic bone and the material characteristics of the internal fixation Material type Material type Poisson's ratio (%) Iliaccrest cortical bone 12400 0.3 Iliaccrest cancellous bone 77 0.3 Acetabular cartilage 12 0.42 femoral cortical bone 15100 0.3 femoral cancellous bone 445 0.22 Plates 110000 0.3 Screws 110000 0.3 Table 2 Material properties of the major ligaments ligament Stiffness N/mm Teres ligament 68 ± 25 Ischiofemoral ligament 39.6 ± 24.4 Pubofemoral ligament 36.9 ± 24.4 Inferior iliofemoral ligament 100.7 ± 54 Superior iliofemoral ligament 97.8 ± 67.5 2.3.3 Loading and Constraints In this study, four different internal fixation methods were simulated and analyzed using the ACPHTF 3D model. The pubic symphysis and sacroiliac joint were securely fixed, restricting their six degrees of freedom to establish the boundary conditions of the model. To simulate partial and full weight-bearing conditions post-operatively for patients with fractures, the load on each assembly model was gradually increased, with forces of 200 N, 400 N, and 600 N applied at the center of the hip joint. Additionally, to simulate the different post-operative positions that patients might adopt, forces were applied at different locations on the pelvis, representing the standing, sitting, and affected side-lying positions. This loading method aimed to simulate various load conditions under real biomechanical scenarios, thereby allowing for a more accurate assessment of the biomechanical performance of different internal fixation methods. 3 Results 3.1 Stress Distribution and Peak Stress First, the strengths of the four internal fixation methods were evaluated. The stress contour maps show that the stress concentration mainly occurred near the fracture lines. Regarding the stress distribution on the plates, in both the standing and affected side-lying positions, as the loading force increased, the anterior column plate of the LACP consistently bore the greatest stress. In the sitting position, with a loading force of 200 N, the ilio-ischial plate of the LACP bore the greatest stress. However, as the loading force increased to 400 N and 600 N, the SQAP exhibited the greatest stress. Compared to the other three plates, the DLP exhibited a lower Von Mises stress under loading forces of 200 N, 400 N, and 600 N. Additionally, under different loading forces and positions, the maximum stress of the CRAP was less than that of the SQAP and LACP but slightly greater than that of the DLP. This indicates that the CRAP system has a more uniform stress distribution, reducing the possibility of stress concentration and internal fixation failure and providing sufficient strength and better mechanical stability (Figs. 3 – 5 and Table 3 ). Figures 3 to 5 are stress contour maps of the four plate groups in standing, sitting, and affected side-lying positions. A-C represent loading forces of 200N, 400N, and 600N, respectively. A, D, G, and J represent the DLP, LACP, SQAP, and CRAP groups, respectively. In A-C, the left side represents the anterior column plate, and the right side represents the posterior column plate. In D-F, the left side represents the anterior column plate, and the right side represents the ilioischial plate. In J-L, the left side represents the reduction plate, and the right side represents the obtained plate. The red areas indicate high stress, while the blue areas indicate low stress. Table 3 Von Mises stress peak values of four groups of plates under different loading modes (MPa) From the stress contour maps, it can be observed that for almost all internal fixation methods, the maximum stress on the screws occurs in the middle-upper part of the screw and at the screw-plate junction. Therefore, these areas must be reinforced to prevent fatigue fractures. In the standing position, as the loading force increased, the stress on the locking screws (LS) of the CRAP was slightly higher than that in the other three groups. Similarly, in the sitting position with loading forces of 200 N and 400 N, the stress on the LS was slightly higher for the CRAP than for the other three plates. When the loading force increased to 600 N, the reduction screws in the CRAP bore the greatest stress. In the affected side-lying position, there were no significant differences in the maximum stress on the screws among the four plates under different loading forces (Figs. 6 – 8 and Table 4 ). Figures 6 to 8 are stress contour maps of the corresponding screws in the four plate groups in standing, sitting, and affected side-lying positions. A-C represent loading forces of 200N, 400N, and 600N, respectively. A, D, G, and J represent the DLP, LACP, SQAP, and CRAP groups, respectively.In A-C, the left side represents the anterior column screws, and the right side represents the posterior column plate. In D-F, the left side represents the anterior column screws, and the right side represents the ilioischial screws. In J-L, the left side represents the reduction screws, and the right side represents the locking screws.The red areas indicate high stress, while the blue areas indicate low stress. 3.2 Micromotion and Maximum Displacement Next, the tangential micromotion at the fracture site and maximum displacement of the pelvis were evaluated for the four internal fixation methods. Micromotion, also known as intermittent motion at the fracture end, is defined as a slight movement between the ends of fracture segments. It not only promotes callus formation and accelerates fracture healing but is also an important mechanical parameter in fracture healing [ 24 , 25 ] . Based on the tangential micromotion contour maps, the LACP exhibited the smallest micromotion (0.001 mm), followed by the combined reduction anatomical plate CRAP at 0.003 mm, with the SQAP showing the largest micromovement at 0.027 mm. The tangential micromotion of the four internal fixation methods showed no significant differences, indicating that the CRAP can offer adequate biomechanical stability. The maximum displacement of the pelvis under the four different internal fixation methods was compared to evaluate the stability of each fixation. It is well-known that displacement is one of the key indicators reflecting the stability of internal fixation [ 26 ]. The maximum displacement of the pelvis includes deformation and rigid-body displacement. The displacement contour maps showed that the maximum displacement of the pelvis with the CRAP (0.855 mm at 600 N in the sitting position) was slightly greater than with the other three fixation methods. The double-column plate group showed relatively smaller displacement in ACPHTF treatment, indicating better stability (as shown in Figs. 9 – 14 and Tables 5 – 6 ). Table 4 Von Mises stress peak values of the four groups of screws under different loading modes and loading forces （ MPa ） Figures 9 to 11 are contour maps showing the maximum displacement of the pelvis under different loading forces and positions for the four internal fixation methods. A-C represent loading forces of 200N, 400N, and 600N, respectively. A, D, G, and J represent the DLP, LACP, SQAP, and CRAP groups, respectively. The deeper the red, the greater the displacement; the lighter the blue, the smaller the displacement. Figures 12 to 14 are contour maps showing the tangential micromotion at the fracture ends under different loading forces and positions for the four internal fixation methods. A-C represent loading forces of 200N, 400N, and 600N, respectively. A, D, G, and J represent the DLP, LACP, SQAP, and CRAP groups, respectively.The deeper the red, the greater the micromotion; the lighter the blue, the smaller the micromotion. Table 5 Maximum displacement of the pelvis under different loading modes and loading forces for the four groups of internal fixation models(mm) Internal fixation model maximum displacement (mm) Standing position Sitting position Standing position 200N 400N 600N 200N 400N 600N 200N 400N 600N CRAP 0.208 0.420 0.670 0.311 0.579 0.855 0.095 0.201 0.276 DLP 0.072 0.097 0.270 0.167 0.335 0.652 0.048 0.090 0.170 SQAP 0.078 0.145 0.212 0.174 0.328 0.495 0.042 0.099 0.151 LACP 0.090 0.099 0.136 0.178 0.377 0.567 0.067 0.121 0.192 Table 6 Tangential fretting of the four groups of internal fixation models under different loading methods and loading forces(mm) Internal fixation model Tangential micromotion(mm) Standing position Sitting position Standing position 200N 400N 600N 200N 400N 600N 200N 400N 600N CRAP 0.007 0.011 0.016 0.005 0.009 0.013 0.003 0.006 0.010 DLP 0.007 0.017 0.025 0.008 0.017 0.021 0.006 0.011 0.017 SQAP 0.006 0.014 0.020 0.008 0.017 0.027 0.006 0.012 0.018 LACP 0.001 0.003 0.005 0.001 0.003 0.004 0.001 0.002 0.004 4 Discussion ACPHTFs are complex acetabular fractures resulting from high-energy trauma, comprising approximately 7% of all acetabular fractures. With an increasingly aging population, its incidence is gradually increasing and is often accompanied by femoral head protrusion and quadrilateral surface displacement, making treatment difficult [ 18 , 27 ] . Open reduction and stable internal fixation have established themselves as the gold standard for treatment [ 2 , 3 ] . Currently, the ideal treatment for the most complex acetabular fractures is the placement of a reconstruction plate from the inner surface of the ilium to the upper surface of the superior pubic ramus. However, single plates often fail to yield satisfactory results. Therefore, surgeons combine posterior column screws, quadrilateral screws, and other plates to reduce the risk of fixation failure [ 28 – 31 ] . Although these methods often yield relatively satisfactory clinical outcomes, the complex and deep anatomical structure of the acetabulum poses surgical risks, such as nerve and vascular damage and screw penetration into the hip joint [ 32 ] . Additionally, these fixation techniques may require more surgical trauma, longer operative times, and greater blood loss. Therefore, based on the anatomical characteristics of the acetabulum, this study reports the design of a specially shaped reconstruction plate (CRAP). However, we have not yet compared the new steel with the traditional method of internal fixation. Therefore, this study used finite element analysis [ 33 ] to compare the biomechanical characteristics and stability differences between the CRAP and traditional fixation methods, thereby providing a theoretical basis for further clinical applications. First, the stress distributions of the new plate and its screws were compared with those of traditional plates and their corresponding screws to evaluate the stiffness of the plate structure based on stress and deformation. Stress distribution indicates the ability of the plate or screws to resist elastic deformation under force. Stress concentration may lead to deformation or even fracture of plates or screws [ 34 ] . From the stress contour maps, it can be observed that under different loading forces, the stresses on the plates and screws were mainly concentrated near the fracture line in all four groups. This indicates that the screws and plates connecting the fracture line bear more force than other positions, which is consistent with the results of previous studies [ 31 , 35 ] . Regarding the stiffness of the plates and screws, under the same load and position, the stress on the CRAP and its screws was greater than that on the SQAP and LACP, but less than that on the DLP. This suggests that the new plate provides sufficient strength and good mechanical stability with a more uniform stress distribution, thereby avoiding internal fixation failure. The maximum stress on the screws mainly occurred in the middle and upper parts of the screws at the screw-plate junction. Therefore, it is necessary to enhance the strength of these parts to prevent fatigue fractures. However, as the loading force increased, there was no significant difference in the maximum stress on the screws among the four groups. Although the new plate and screws bear greater stress, the maximum stress is far below the yield strength of the titanium alloy material, which can withstand a maximum stress of 795 MPa [ 36 ] . Finally, the plates and screws in the double-column plate group bore less stress because the fixation included two plates, which could effectively distribute the stress, consistently with previous studies [ 37 , 38 ] . Next, we assessed four internal fixation methods for tangential micromotion at the fracture site and maximum pelvic displacement. Micromotion not only promotes callus formation and accelerates fracture healing but is also an important mechanical parameter in the fracture healing process [ 24 , 25 ] . Therefore, we evaluated the micromotion of the four internal fixation methods. From the tangential micromotion contour maps, there is no significant difference in tangential micromotion among the four internal fixation methods, indicating that CRAP provides sufficient biomechanical stability. The maximum displacement of the pelvis under the four internal fixation methods was compared to evaluate their stability. As is well-known, displacement also reflects the stability of internal fixation [ 26 ] . The maximum displacement of the pelvis includes both deformation and rigid-body displacement. The displacement contour maps showed that the maximum pelvic displacement was slightly larger with the CRAP than that with the other three internal fixation methods. The smallest maximum displacement was observed in the double-column plate group when treating ACPHTFs, demonstrating the best stability. However, the insertion of double-column plates requires a combined anterior-posterior approach, which has disadvantages such as greater exposure, increased risk of soft tissue damage, neurovascular injury, and longer operative time [ 20 , 39 ] . Although the maximum displacement with the CRAP is larger, previous studies have shown that under stress, there will be some relative displacement between the fracture fragments. This relative displacement in the range of 0.2–1.0 mm can stimulate callus formation and promote fracture healing, whereas displacements greater than 2 mm are detrimental to fracture healing. In this study, the maximum displacement of fractures with all four internal fixation devices under different loads was less than 1 mm, indicating that they are biomechanically conducive to fracture healing [ 26 , 40 – 42 ] . Therefore, compared to the other three internal fixation methods, CRAP provides sufficient stability and can be considered the preferred choice for the treatment of ACPHTFs. This study is the first to conduct a finite element analysis of the lateral decubitus position, which is relevant because patients may rest in the lateral decubitus position on the affected side post-operatively. The analysis focused on stress distribution, stress peaks, and other factors when patients rest in this position post-operatively. From the stress contour maps, it can be observed that as the load increases, the new plate and its screws provide sufficient strength and biomechanical stability, preventing internal fixation failure. Micromotion and maximum displacement of the pelvis indicate that in the lateral decubitus position, the CRAP provides adequate stability. Therefore, using CRAP to treat ACPHTFs ensures that regardless of the post-operative position the patient adopts, there will be no internal fixation failure or femoral head dislocation. The CRAP is considered a safe and effective treatment option. In summary, this study demonstrated that the double-column plate group endured the least stress and provided the highest stability when treating ACPHTFs, which is consistent with previous research on acetabular fracture treatment [ 10 , 37 , 43 ] . However, double-column plate fixation has drawbacks, such as significant surgical trauma, a higher risk of neurovascular injury, and prolonged operative time [ 20 , 39 ] . Single-column plate fixation for acetabular fractures shows greater stress concentration and poorer biomechanical stability [ 20 , 37 , 44 ] . To address these limitations, we designed a novel combination of anatomical reduction plates. This fixation system benefits from the stress distribution and stability provided by the two plates and allows effective reduction and fixation of the acetabular quadrilateral, posterior column, and posterior wall fractures through a simple posterior Kocher-Langenbeck approach. This approach overcomes the difficulties associated with traditional combined anterior and posterior approaches for treating complex acetabular fractures. Furthermore, the CRAP was designed based on the acetabular morphology of Chinese patients, making it more anatomically compatible than traditional plates. This novel plate is pre-contoured to match the acetabular surface, avoiding intra-operative pre-bending and shaping, thereby significantly reducing operative time and trauma [ 15 ] . In this study, the establishment of the finite element models and their parameters followed those of previous studies [ 45, 46] that employed similar loading and boundary conditions. Therefore, we consider this study reasonable and reliable. However, our study had some limitations. First, our study was based on computer simulations rather than real-world experiments. The finite element models used in this study were simplified and did not account for the influence of surrounding soft tissues on the fixation methods; therefore, they may not accurately reflect physiological conditions. Nevertheless, previous studies have shown that biomechanical studies based on computer simulations can still provide effective theoretical support for pelvic fracture fixation [ 37, 38]. Therefore, further biomechanical studies using artificial or cadaveric pelvises are needed to validate these findings. Finally, this study compared only four types of internal fixation methods for ACPHTF; other fixation methods for acetabular fractures should be compared in future research. 5 Conclusion In conclusion, compared to the traditional three internal fixation methods, the CRAP and its accompanying screws exhibit more uniform stress distribution and greater stiffness, providing sufficient strength and superior mechanical stability. Additionally, no significant differences were observed in interfragmentary motion among the four internal fixation methods, indicating that the CRAP can offer adequate biomechanical stability and is more favorable for fracture healing. Therefore, the CRAP fixation method presented in this study is a safe and effective option for treating ACPHTFs. Declarations Ethics approval and consent to participate：This study was approved by the Institutional Review Board of the Afliated Hospital of Zunyi Medical University, Zunyi, Guizho, China, Ethics number KLLY-2022-017. All subjects provided informed consent to take part in the study. All procedures were conducted according to the 1964 Declaration of Helsinki and its amendments. Conflict of Interest: The authors declare that there are no conflicts of interest. Author Contributions: Chen Lin: Participated in study design, Data measurement, data analysis, and main contributor to writing the paper. Bao Chongshuai and Wang Ansu: Prepared figures and tables. Ao Jun: data analysis, and paper revision. All the authors read and approved the final manuscript. Funding: The work was supported by the Project of the Provincial and Ministerial Collaborative Innovation Center (No.39 [2020] of the Science and Technology Agency). Acknowledgments: The authors are grateful to the research participants and all the hospital staff who took an interest and helped with the study. 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Sawaguchi, T., T.D. Brown, H.E. Rubash, et al., Stability of acetabular fractures after internal fixation. A cadaveric study. Acta Orthop Scand, 1984. 55(6): p. 601-605. Wu, Y.D., X.H. Cai, X.M. Liu, et al., Biomechanical analysis of the acetabular buttress-plate: are complex acetabular fractures in the quadrilateral area stable after treatment with anterior construct plate-1/3 tube buttress plate fixation? Clinics (Sao Paulo), 2013. 68(7): p. 1028-1033. Andersen, R.C., R.V. O'Toole, J.W. Nascone, et al., Modified stoppa approach for acetabular fractures with anterior and posterior column displacement: quantification of radiographic reduction and analysis of interobserver variability. J. Orthop. Trauma, 2010. 24(5): p. 271-278. Lei, J., P. Dong, Z. Li, et al., Biomechanical analysis of the fixation systems for anterior column and posterior hemi-transverse acetabular fractures. Acta Orthop. Traumatol. Turc., 2017. 51(3): p. 248-253. Wu, H., R. Shang, X. Cai, et al., Single Ilioinguinal Approach to Treat Complex Acetabular Fractures with Quadrilateral Plate Involvement: Outcomes Using a Novel Dynamic Anterior Plate-Screw System. Orthop. Surg., 2020. 12(2): p. 488-497. Li, D., H. Ren, X. Zhang, et al., Finite Element Analysis of Channel Screw and Conventional Plate Technique in Tile B2 Pelvic Fracture. J Pers Med, 2023. 13(3). Zhang, D., N. Liu, Y. Chen, et al., Microstructure Evolution and Mechanical Properties of PM-Ti43Al9V0.3Y Alloy. Materials (Basel), 2020. 13(1). Brolin, K. and P. Halldin, Development of a finite element model of the upper cervical spine and a parameter study of ligament characteristics. Spine, 2004. 29(4): p. 376-385. Pei Xuan, Huang Jincheng, Qian Shenglong, Zhou Wei, Ke Xi, Wang Guodong, et al. (2023). Finite Element Analysis of Five Internal Fixation Methods for Treating Day II Type Pelvic Crescent Fracture-Dislocation. Chinese Journal of Reparative and Reconstructive Surgery. 37(10), 1205-1213. Li, M., J. Deng, J. Li, et al., A Novel Anatomical Locking Guide Plate for Treating Acetabular Transverse Posterior Wall Fracture: A Finite Element Analysis Study. Orthop. Surg., 2022. 14(10): p. 2648-2656. Deng, J., M. Li, J. Li, et al., Finite Element Analysis of a Novel Anatomical Locking Guide Plate for Anterior Column and Posterior Hemi-Transverse Acetabular Fractures %J Journal of Medical and Biological Engineering. 2021(prepublish): p. 1-9. Giordano, V., N.P. do Amaral, A. Pallottino, et al., Operative treatment of transverse acetabular fractures: is it really necessary to fix both columns? Int. J. Med. Sci., 2009. 6(4): p. 192-199. Steiner, M., L. Claes, A. Ignatius, et al., Numerical simulation of callus healing for optimization of fracture fixation stiffness. PLoS One, 2014. 9(7): p. e101370. Shi Jinyou, Xiao Yuzhou, Wu Min, and Guan Jianzhong (2021). Study on the Nature of Micromotion and Biomechanical Staging of Fracture Healing. Chinese Journal of Reparative and Reconstructive Surgery.35(09) , 1205-1211. Epari, D.R., R. Gurung, L. Hofmann-Fliri, et al., Biphasic plating improves the mechanical performance of locked plating for distal femur fractures. J. Biomech., 2021. 115: p. 110192. Tosounidis, T.H. and P.V. Giannoudis, What is new in acetabular fracture fixation? Injury, 2015. 46(11): p. 2089-2092. Cahueque, M., M. Martínez, A. Cobar, et al., Early reduction of acetabular fractures decreases the risk of post-traumatic hip osteoarthritis? J Clin Orthop Trauma, 2017. 8(4): p. 320-326. Anderson, A.E., C.L. Peters, B.D. Tuttle, et al., Subject-specific finite element model of the pelvis: development, validation and sensitivity studies. #N/A, 2005. 127(3): p. 364-373. Dalstra, M. and R. Huiskes, Load transfer across the pelvic bone. J. Biomech., 1995. 28(6): p. 715-724. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4964573","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":349500295,"identity":"6a665043-f6eb-418d-9ff0-9efd6989758e","order_by":0,"name":"Lin Chen","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAy0lEQVRIiWNgGAWjYDACCSB+YMDAYMDAfODAhx/EakkAa2FLPDizh2gtDCAtPMaHOdiI0ME/u/nYg4SCO4nbJXI+HGbgYZDnFztAwJI7x9INEgyeJe6ckbvhcIEFg+HM2Qn4tRhI5JhJJBgczt1wA6hlBg/QX7cJasn/BtWS8+AwDxtRWnLYYFoYiNMicSMN7LD6DWeeGQADWYKwX/hnJD+T+PDnsLHB8eTHHz78sJHnlyagBQEEwColiFUOtu8AKapHwSgYBaNgJAEA36NLA2yveO4AAAAASUVORK5CYII=","orcid":"","institution":"The Affiliated Hospital of Zunyi Medical University","correspondingAuthor":true,"prefix":"","firstName":"Lin","middleName":"","lastName":"Chen","suffix":""},{"id":349500296,"identity":"ad206a70-aec5-407e-823c-0936bdbe438b","order_by":1,"name":"Chongshuai Bao","email":"","orcid":"","institution":"The Affiliated Hospital of Zunyi Medical University","correspondingAuthor":false,"prefix":"","firstName":"Chongshuai","middleName":"","lastName":"Bao","suffix":""},{"id":349500297,"identity":"191b962a-ac8e-42ec-9a2c-c804f1cfd5e6","order_by":2,"name":"Ao Jun","email":"","orcid":"","institution":"The Affiliated Hospital of Zunyi Medical University","correspondingAuthor":false,"prefix":"","firstName":"Ao","middleName":"","lastName":"Jun","suffix":""},{"id":349500298,"identity":"f0c134a9-38e2-4a8e-9419-40ad099ad24e","order_by":3,"name":"Ansu Wang","email":"","orcid":"","institution":"The Affiliated Hospital of Zunyi Medical University","correspondingAuthor":false,"prefix":"","firstName":"Ansu","middleName":"","lastName":"Wang","suffix":""}],"badges":[],"createdAt":"2024-08-23 13:29:44","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4964573/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4964573/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":66951935,"identity":"d016b087-c5c3-4bdb-b3b4-2ab85c92fdb9","added_by":"auto","created_at":"2024-10-18 10:29:16","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":21774,"visible":true,"origin":"","legend":"\u003cp\u003e3D models of a normal acetabulum and an anterior column-posterior hemitransverse fracture (ACPHTF). 1a shows the normal acetabulum model, while 1b illustrates the ACPHTF model and fracture lines, with different colors distinguishing the fracture fragments.\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4964573/v1/8518d4d4b704172c3d2bf253.jpg"},{"id":66950937,"identity":"e3846cc9-bd7f-4ff6-836d-8985f4c7f0dd","added_by":"auto","created_at":"2024-10-18 10:21:16","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":19453,"visible":true,"origin":"","legend":"\u003cp\u003eFour ACPHTF internal fixation models. a~d represent the combined anatomical reduction plate, anterior column-posterior column plate, suprapectineal quadrilateral plate, and ilio-ischial-anterior column plate, respectively.\u003c/p\u003e","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4964573/v1/d9c1f17ed7c5ba6e6b0bcfec.jpg"},{"id":66950940,"identity":"d70326e9-3ea3-4dfe-9e16-8a86bdc75b68","added_by":"auto","created_at":"2024-10-18 10:21:16","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":85203,"visible":true,"origin":"","legend":"\u003cp\u003eFigures 3 to 5 are stress contour maps of the four plate groups in standing, sitting, and affected side-lying positions. A-C represent loading forces of 200N, 400N, and 600N, respectively. A, D, G, and J represent the DLP, LACP, SQAP, and CRAP groups, respectively. In A-C, the left side represents the anterior column plate, and the right side represents the posterior column plate. In D-F, the left side represents the anterior column plate, and the right side represents the ilioischial plate. In J-L, the left side represents the reduction plate, and the right side represents the obtained plate. The red areas indicate high stress, while the blue areas indicate low stress.\u003c/p\u003e","description":"","filename":"3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4964573/v1/aea143ee120ed902e2528bba.jpg"},{"id":66950939,"identity":"b976c26f-6d8b-408d-a25d-7db1d0ea3baf","added_by":"auto","created_at":"2024-10-18 10:21:16","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":83019,"visible":true,"origin":"","legend":"\u003cp\u003eFigures 3 to 5 are stress contour maps of the four plate groups in standing, sitting, and affected side-lying positions. A-C represent loading forces of 200N, 400N, and 600N, respectively. A, D, G, and J represent the DLP, LACP, SQAP, and CRAP groups, respectively. In A-C, the left side represents the anterior column plate, and the right side represents the posterior column plate. In D-F, the left side represents the anterior column plate, and the right side represents the ilioischial plate. In J-L, the left side represents the reduction plate, and the right side represents the obtained plate. The red areas indicate high stress, while the blue areas indicate low stress.\u003c/p\u003e","description":"","filename":"4.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4964573/v1/97c9203414d29d8aa636d90d.jpg"},{"id":66951936,"identity":"128fc0ad-a7c4-422a-a257-45f462d6b687","added_by":"auto","created_at":"2024-10-18 10:29:16","extension":"jpg","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":79298,"visible":true,"origin":"","legend":"\u003cp\u003eFigures 3 to 5 are stress contour maps of the four plate groups in standing, sitting, and affected side-lying positions. A-C represent loading forces of 200N, 400N, and 600N, respectively. A, D, G, and J represent the DLP, LACP, SQAP, and CRAP groups, respectively. In A-C, the left side represents the anterior column plate, and the right side represents the posterior column plate. In D-F, the left side represents the anterior column plate, and the right side represents the ilioischial plate. In J-L, the left side represents the reduction plate, and the right side represents the obtained plate. The red areas indicate high stress, while the blue areas indicate low stress.\u003c/p\u003e","description":"","filename":"5.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4964573/v1/949845de7e381087b2f74fa9.jpg"},{"id":66953938,"identity":"7af7666e-73b5-4885-a648-5fea6c49ad7b","added_by":"auto","created_at":"2024-10-18 10:53:16","extension":"jpg","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":66397,"visible":true,"origin":"","legend":"\u003cp\u003eFigures 6 to 8 are stress contour maps of the corresponding screws in the four plate groups in standing, sitting, and affected side-lying positions. A-C represent loading forces of 200N, 400N, and 600N, respectively. A, D, G, and J represent the DLP, LACP, SQAP, and CRAP groups, respectively.In A-C, the left side represents the anterior column screws, and the right side represents the posterior column plate. In D-F, the left side represents the anterior column screws, and the right side represents the ilioischial screws. In J-L, the left side represents the reduction screws, and the right side represents the locking screws.The red areas indicate high stress, while the blue areas indicate low stress.\u003c/p\u003e","description":"","filename":"6.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4964573/v1/be37acc27241a87640b015cc.jpg"},{"id":66950942,"identity":"29c9e496-b954-4907-bd75-6143c911f57c","added_by":"auto","created_at":"2024-10-18 10:21:16","extension":"jpg","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":86818,"visible":true,"origin":"","legend":"\u003cp\u003eFigures 6 to 8 are stress contour maps of the corresponding screws in the four plate groups in standing, sitting, and affected side-lying positions. A-C represent loading forces of 200N, 400N, and 600N, respectively. A, D, G, and J represent the DLP, LACP, SQAP, and CRAP groups, respectively.In A-C, the left side represents the anterior column screws, and the right side represents the posterior column plate. In D-F, the left side represents the anterior column screws, and the right side represents the ilioischial screws. In J-L, the left side represents the reduction screws, and the right side represents the locking screws.The red areas indicate high stress, while the blue areas indicate low stress.\u003c/p\u003e","description":"","filename":"7.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4964573/v1/2ad26f10a932323035658b57.jpg"},{"id":66952503,"identity":"7eab343c-0748-4d2a-87d3-9a8ec7ccbd95","added_by":"auto","created_at":"2024-10-18 10:37:16","extension":"jpg","order_by":8,"title":"Figure 8","display":"","copyAsset":false,"role":"figure","size":88966,"visible":true,"origin":"","legend":"\u003cp\u003eFigures 6 to 8 are stress contour maps of the corresponding screws in the four plate groups in standing, sitting, and affected side-lying positions. A-C represent loading forces of 200N, 400N, and 600N, respectively. A, D, G, and J represent the DLP, LACP, SQAP, and CRAP groups, respectively.In A-C, the left side represents the anterior column screws, and the right side represents the posterior column plate. In D-F, the left side represents the anterior column screws, and the right side represents the ilioischial screws. In J-L, the left side represents the reduction screws, and the right side represents the locking screws.The red areas indicate high stress, while the blue areas indicate low stress.\u003c/p\u003e","description":"","filename":"8.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4964573/v1/41635b5f4e9cc8c8b8e99a4a.jpg"},{"id":66953670,"identity":"30405b40-ad07-4603-b633-247e413e5061","added_by":"auto","created_at":"2024-10-18 10:45:16","extension":"jpg","order_by":9,"title":"Figure 9","display":"","copyAsset":false,"role":"figure","size":123366,"visible":true,"origin":"","legend":"\u003cp\u003eFigures 9 to 11 are contour maps showing the maximum displacement of the pelvis under different loading forces and positions for the four internal fixation methods. A-C represent loading forces of 200N, 400N, and 600N, respectively. A, D, G, and J represent the DLP, LACP, SQAP, and CRAP groups, respectively. The deeper the red, the greater the displacement; the lighter the blue, the smaller the displacement.\u003c/p\u003e","description":"","filename":"9.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4964573/v1/f6f6dd085cc52af20f61ea20.jpg"},{"id":66951938,"identity":"e931cd23-92ab-4223-861c-cc356185a30e","added_by":"auto","created_at":"2024-10-18 10:29:16","extension":"jpg","order_by":10,"title":"Figure 10","display":"","copyAsset":false,"role":"figure","size":117886,"visible":true,"origin":"","legend":"\u003cp\u003eFigures 9 to 11 are contour maps showing the maximum displacement of the pelvis under different loading forces and positions for the four internal fixation methods. A-C represent loading forces of 200N, 400N, and 600N, respectively. A, D, G, and J represent the DLP, LACP, SQAP, and CRAP groups, respectively. The deeper the red, the greater the displacement; the lighter the blue, the smaller the displacement.\u003c/p\u003e","description":"","filename":"10.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4964573/v1/a18521a96e44cea6b580ad1a.jpg"},{"id":66950949,"identity":"f9ef37ea-8838-46d9-bf16-2d2f2156c722","added_by":"auto","created_at":"2024-10-18 10:21:16","extension":"jpg","order_by":11,"title":"Figure 11","display":"","copyAsset":false,"role":"figure","size":117813,"visible":true,"origin":"","legend":"\u003cp\u003eFigures 9 to 11 are contour maps showing the maximum displacement of the pelvis under different loading forces and positions for the four internal fixation methods. A-C represent loading forces of 200N, 400N, and 600N, respectively. A, D, G, and J represent the DLP, LACP, SQAP, and CRAP groups, respectively. The deeper the red, the greater the displacement; the lighter the blue, the smaller the displacement.\u003c/p\u003e","description":"","filename":"11.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4964573/v1/bee2b70f3ecb7dc3b91a177d.jpg"},{"id":66951940,"identity":"aef7527d-a68b-410e-86ec-6d743ac85714","added_by":"auto","created_at":"2024-10-18 10:29:16","extension":"jpg","order_by":12,"title":"Figure 12","display":"","copyAsset":false,"role":"figure","size":107779,"visible":true,"origin":"","legend":"\u003cp\u003eFigures 12 to 14 are contour maps showing the tangential micromotion at the fracture ends under different loading forces and positions for the four internal fixation methods. A-C represent loading forces of 200N, 400N, and 600N, respectively. A, D, G, and J represent the DLP, LACP, SQAP, and CRAP groups, respectively.The deeper the red, the greater the micromotion; the lighter the blue, the smaller the micromotion.\u003c/p\u003e","description":"","filename":"12.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4964573/v1/b9f067fa50a49d1f7c42e819.jpg"},{"id":66950947,"identity":"7bbe28f4-a155-4984-b9fe-25a56e8981c9","added_by":"auto","created_at":"2024-10-18 10:21:16","extension":"jpg","order_by":13,"title":"Figure 13","display":"","copyAsset":false,"role":"figure","size":108119,"visible":true,"origin":"","legend":"\u003cp\u003eFigures 12 to 14 are contour maps showing the tangential micromotion at the fracture ends under different loading forces and positions for the four internal fixation methods. A-C represent loading forces of 200N, 400N, and 600N, respectively. A, D, G, and J represent the DLP, LACP, SQAP, and CRAP groups, respectively.The deeper the red, the greater the micromotion; the lighter the blue, the smaller the micromotion.\u003c/p\u003e","description":"","filename":"13.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4964573/v1/65cdfd39900a2127f4bba87f.jpg"},{"id":66951942,"identity":"ab11afdb-9a5c-40c2-952d-11e59a15f347","added_by":"auto","created_at":"2024-10-18 10:29:16","extension":"jpg","order_by":14,"title":"Figure 14","display":"","copyAsset":false,"role":"figure","size":109067,"visible":true,"origin":"","legend":"\u003cp\u003eFigures 12 to 14 are contour maps showing the tangential micromotion at the fracture ends under different loading forces and positions for the four internal fixation methods. A-C represent loading forces of 200N, 400N, and 600N, respectively. A, D, G, and J represent the DLP, LACP, SQAP, and CRAP groups, respectively.The deeper the red, the greater the micromotion; the lighter the blue, the smaller the micromotion.\u003c/p\u003e","description":"","filename":"14.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4964573/v1/d8640e8c03db6339e5ac153b.jpg"},{"id":72602783,"identity":"72ea61e8-3230-47ff-a51f-42aaeee39899","added_by":"auto","created_at":"2024-12-30 09:08:56","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1950591,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4964573/v1/df05c84b-da84-4960-a13f-8006b0bb8407.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"A new combined reduction anatomical plate for the treatment of acetabular anterior column and posterior hemi-transverse fractures: a finite element analysis study","fulltext":[{"header":"1 Introduction","content":"\u003cp\u003eAcetabular fractures, intricate fractures occurring within the joint, are primarily the result of high-impact trauma. Recently, their frequency has risen due to a higher occurrence of traffic and industrial accidents\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e. To maximize the restoration of hip joint function, improve prognosis, and reduce the occurrence of complications, the preferred method for treating displaced acetabular fractures is now open reduction and internal fixation\u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e. According to the Judet-Letournel\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e classification system, quadrilateral plate fractures are not classified separately, except for simple anterior and posterior wall fractures; still, 80% of the other fracture types may involve the quadrilateral plate\u003csup\u003e[\u003cspan additionalcitationids=\"CR6\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e. This is particularly true in elderly patients, who often have osteoporosis and comminuted fractures\u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eAnterior column-posterior hemi-transverse fractures (ACPHTFs) are a common type of acetabular fracture, often accompanied by femoral head protrusion and quadrilateral plate displacement \u003csup\u003e[\u003cspan additionalcitationids=\"CR10\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/sup\u003e. This fracture impacts both the anterior and posterior columns and involves the quadrilateral plate. Presently, it is considered that only anatomical reduction, which restores the smoothness and flatness of the hip joint, preserves the blood supply to the femoral head and intra-articular fractures, provides stable internal fixation, and can achieve good clinical outcomes \u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e. However, due to the deep location of the quadrilateral plate, limited surgical space, difficulty in intra-operative exposure, and issues with traditional pelvic plates, such as difficulty in shaping during surgery, poor fit with pelvic anatomical structures, single fixation points, inadequate reduction, fixation of quadrilateral plate fractures, and screws easily entering the hip joint, leading to femoral head necrosis and traumatic arthritis \u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e, these traditional methods no longer meet the requirements for precise reduction and strong fixation of this type of fracture.\u003c/p\u003e \u003cp\u003eTherefore, we designed a specially shaped reconstruction plate (the Combined Reduction Anatomical Plate, CRAP) based on the anatomical characteristics of the acetabulum, which has been granted a Chinese national patent (Patent No.: CN202222137846.2). This fixation system includes two components: a locking plate and a reduction plate. The locking plate is a curved strip designed to fit above the greater sciatic notch, while the reduction plate is contoured to align with the anatomical structures above the acetabulum and the quadrilateral plate. This system is primarily used for treating acetabular fractures that involve the quadrilateral plate, such as posterior column fractures, T-type fractures, ACPHT, and both-column fractures. Considering the extremely irregular shape of the pelvis and the difficulty in shaping plates during surgery, we previously conducted an anatomical study on the CRAP fixation trajectory using computer-aided anatomical measurements. This study led to the design of anatomical plates and reduced the difficulty of shaping traditional plates during surgery \u003csup\u003e[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e. However, comparative studies on the biomechanical properties of the newly designed CRAP and traditional plates have not been conducted, particularly regarding the biomechanical mechanisms during bone healing.\u003c/p\u003e \u003cp\u003eTherefore, this study aimed to use the finite element method to compare the biomechanical properties and stability differences of four internal fixation methods for treating anterior column-posterior hemi-transverse fractures: combined reduction anatomical plate (CRAP), anterior column-posterior column plate (DLP), supra-pectineal quadrilateral plate (SQAP), and ilio-ischial-anterior column plate (LACP). This research offers a theoretical foundation for the expanded clinical use of the CRAP.\u003c/p\u003e"},{"header":"2 Materials and Methods","content":"\u003cp\u003e\u003cstrong\u003e2.1 Establishment of the three-dimensional Finite Element Model for Anterior Column-Posterior Hemi-transverse Fractures\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA healthy 23-year-old male volunteer provided informed consent. Pelvic radiography excluded fractures, deformities, tumors, and other pathologies. This research received approval from our hospital\u0026apos;s Medical Ethics Committee (ethics no. KLLY-2022-017). The DICOM data from the volunteers were imported into Mimics software (version 21.0, Materialise Company, Leuven, Belgium). The hemi-pelvic model was reconstructed and exported in STL format, followed by software construction of a standard finite element model (Fig. \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003ea).\u003c/p\u003e\n\u003cp\u003eThe ACPHTF model was established according to the Judet and Letournel classification of acetabular fractures\u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e. ACPHTFs primarily have two fracture lines: one extends from the anterior superior iliac spine to the inferior edge of the obturator foramen. The other extends from the midpoint of the first fracture line to the uppermost end of the sciatic notch (Fig. \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003eb) \u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.2 Modelling of Four Internal Fixation Models for Anterior Column-Posterior Hemi-transverse Fractures\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn this study, four internal fixation models (CRAP, DLP, SQP, and LCAP) were accurately constructed using SolidWorks 2017 software (SolidWorks Corporation, Dassault, France) based on the actual dimensions and shapes of the fixation devices. During the construction process, special attention was paid to the design characteristics of each fixation device, such as shape, size, and intended biomechanical application, to ensure model realism and functionality. After construction, these models were precisely assembled onto the ACPHTF model for subsequent finite element analysis (Fig. \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.3 Definition of Boundary Conditions, Material Properties, and Loads\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe analysis was conducted using the ANSYS Workbench 2022 R1 (Ansys, Canonsburg, PA) software to generate standardized finite element models.\u003c/p\u003e\n\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003e2.3.1 Boundary Conditions\u003c/h2\u003e\n \u003cp\u003eIn the model, the contact between the bone surface and the internal fixation devices or between the internal fixation devices themselves was set as bonded contact. The contact between fracture fragments and cartilage was set as frictional contact with a friction coefficient of 0.2 to simulate physiological conditions.\u003c/p\u003e\n \u003cdiv id=\"Sec4\" class=\"Section3\"\u003e\n \u003ch2\u003e2.3.2 Material Properties\u003c/h2\u003e\n \u003cp\u003eTo construct the model, we assumed that all cortical bones, cancellous bones, plates, and screws were homogeneous and isotropic. To make the finite element model closer to physiological conditions, acetabular cartilage was included, and the ligaments were defined based on their anatomical locations. The standard finite element model defined the iliofemoral, ischiofemoral, pubofemoral, inferior iliofemoral, and superior iliofemoral ligaments. The material properties of the cortical bone, cancellous bone, articular cartilage, and ligaments were determined based on previous literature \u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/sup\u003e. The material properties are listed in Tables \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e and \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\n \u003cp\u003e\u003c/p\u003e\n \u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eThe composition of the various parts of the pelvic bone and the material characteristics of the internal fixation\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMaterial type\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMaterial type\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePoisson\u0026apos;s ratio (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIliaccrest cortical bone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e12400\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIliaccrest cancellous bone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAcetabular cartilage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003efemoral cortical bone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e15100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003efemoral cancellous bone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e445\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePlates\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e110000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eScrews\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e110000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003cp\u003e\u003c/p\u003e\u0026nbsp;\u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eMaterial properties of the major ligaments\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eligament\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eStiffness N/mm\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTeres ligament\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e68\u0026thinsp;\u0026plusmn;\u0026thinsp;25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIschiofemoral ligament\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e39.6\u0026thinsp;\u0026plusmn;\u0026thinsp;24.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePubofemoral ligament\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e36.9\u0026thinsp;\u0026plusmn;\u0026thinsp;24.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eInferior iliofemoral ligament\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e100.7\u0026thinsp;\u0026plusmn;\u0026thinsp;54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSuperior iliofemoral ligament\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e97.8\u0026thinsp;\u0026plusmn;\u0026thinsp;67.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cdiv id=\"Sec5\" class=\"Section3\"\u003e\n \u003ch2\u003e2.3.3 Loading and Constraints\u003c/h2\u003e\n \u003cp\u003eIn this study, four different internal fixation methods were simulated and analyzed using the ACPHTF 3D model. The pubic symphysis and sacroiliac joint were securely fixed, restricting their six degrees of freedom to establish the boundary conditions of the model. To simulate partial and full weight-bearing conditions post-operatively for patients with fractures, the load on each assembly model was gradually increased, with forces of 200 N, 400 N, and 600 N applied at the center of the hip joint. Additionally, to simulate the different post-operative positions that patients might adopt, forces were applied at different locations on the pelvis, representing the standing, sitting, and affected side-lying positions. This loading method aimed to simulate various load conditions under real biomechanical scenarios, thereby allowing for a more accurate assessment of the biomechanical performance of different internal fixation methods.\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e"},{"header":"3 Results","content":"\u003cp\u003e\u003cstrong\u003e3.1 Stress Distribution and Peak Stress\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFirst, the strengths of the four internal fixation methods were evaluated. The stress contour maps show that the stress concentration mainly occurred near the fracture lines. Regarding the stress distribution on the plates, in both the standing and affected side-lying positions, as the loading force increased, the anterior column plate of the LACP consistently bore the greatest stress. In the sitting position, with a loading force of 200 N, the ilio-ischial plate of the LACP bore the greatest stress. However, as the loading force increased to 400 N and 600 N, the SQAP exhibited the greatest stress.\u003c/p\u003e\n\u003cp\u003eCompared to the other three plates, the DLP exhibited a lower Von Mises stress under loading forces of 200 N, 400 N, and 600 N. Additionally, under different loading forces and positions, the maximum stress of the CRAP was less than that of the SQAP and LACP but slightly greater than that of the DLP. This indicates that the CRAP system has a more uniform stress distribution, reducing the possibility of stress concentration and internal fixation failure and providing sufficient strength and better mechanical stability (Figs. \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e and Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003eFigures \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e to \u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e are stress contour maps of the four plate groups in standing, sitting, and affected side-lying positions. A-C represent loading forces of 200N, 400N, and 600N, respectively. A, D, G, and J represent the DLP, LACP, SQAP, and CRAP groups, respectively. In A-C, the left side represents the anterior column plate, and the right side represents the posterior column plate. In D-F, the left side represents the anterior column plate, and the right side represents the ilioischial plate. In J-L, the left side represents the reduction plate, and the right side represents the obtained plate. The red areas indicate high stress, while the blue areas indicate low stress.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3 Von Mises stress peak values of four groups of plates under different loading modes (MPa)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cimg 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\" width=\"779\" height=\"348\"\u003e\u003c/strong\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eFrom the stress contour maps, it can be observed that for almost all internal fixation methods, the maximum stress on the screws occurs in the middle-upper part of the screw and at the screw-plate junction. Therefore, these areas must be reinforced to prevent fatigue fractures. In the standing position, as the loading force increased, the stress on the locking screws (LS) of the CRAP was slightly higher than that in the other three groups. Similarly, in the sitting position with loading forces of 200 N and 400 N, the stress on the LS was slightly higher for the CRAP than for the other three plates. When the loading force increased to 600 N, the reduction screws in the CRAP bore the greatest stress. In the affected side-lying position, there were no significant differences in the maximum stress on the screws among the four plates under different loading forces (Figs. \u003cspan class=\"InternalRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan class=\"InternalRef\"\u003e8\u003c/span\u003e and Table \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003eFigures \u003cspan class=\"InternalRef\"\u003e6\u003c/span\u003e to \u003cspan class=\"InternalRef\"\u003e8\u003c/span\u003e are stress contour maps of the corresponding screws in the four plate groups in standing, sitting, and affected side-lying positions. A-C represent loading forces of 200N, 400N, and 600N, respectively. A, D, G, and J represent the DLP, LACP, SQAP, and CRAP groups, respectively.In A-C, the left side represents the anterior column screws, and the right side represents the posterior column plate. In D-F, the left side represents the anterior column screws, and the right side represents the ilioischial screws. In J-L, the left side represents the reduction screws, and the right side represents the locking screws.The red areas indicate high stress, while the blue areas indicate low stress.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.2 Micromotion and Maximum Displacement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNext, the tangential micromotion at the fracture site and maximum displacement of the pelvis were evaluated for the four internal fixation methods. Micromotion, also known as intermittent motion at the fracture end, is defined as a slight movement between the ends of fracture segments. It not only promotes callus formation and accelerates fracture healing but is also an important mechanical parameter in fracture healing \u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/sup\u003e. Based on the tangential micromotion contour maps, the LACP exhibited the smallest micromotion (0.001 mm), followed by the combined reduction anatomical plate CRAP at 0.003 mm, with the SQAP showing the largest micromovement at 0.027 mm. The tangential micromotion of the four internal fixation methods showed no significant differences, indicating that the CRAP can offer adequate biomechanical stability. The maximum displacement of the pelvis under the four different internal fixation methods was compared to evaluate the stability of each fixation. It is well-known that displacement is one of the key indicators reflecting the stability of internal fixation \u003csup\u003e[\u003cspan class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e]. The maximum displacement of the pelvis includes deformation and rigid-body displacement. The displacement contour maps showed that the maximum displacement of the pelvis with the CRAP (0.855 mm at 600 N in the sitting position) was slightly greater than with the other three fixation methods. The double-column plate group showed relatively smaller displacement in ACPHTF treatment, indicating better stability (as shown in Figs. \u003cspan class=\"InternalRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan class=\"InternalRef\"\u003e14\u003c/span\u003e and Tables \u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4 Von Mises stress peak values of the four groups of screws under different loading modes and loading forces\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003eMPa\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cimg 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\" width=\"742\" height=\"321\"\u003e\u003c/strong\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eFigures \u003cspan class=\"InternalRef\"\u003e9\u003c/span\u003e to \u003cspan class=\"InternalRef\"\u003e11\u003c/span\u003e are contour maps showing the maximum displacement of the pelvis under different loading forces and positions for the four internal fixation methods. A-C represent loading forces of 200N, 400N, and 600N, respectively. A, D, G, and J represent the DLP, LACP, SQAP, and CRAP groups, respectively. The deeper the red, the greater the displacement; the lighter the blue, the smaller the displacement.\u003c/p\u003e\n\u003cp\u003eFigures \u003cspan class=\"InternalRef\"\u003e12\u003c/span\u003e to \u003cspan class=\"InternalRef\"\u003e14\u003c/span\u003e are contour maps showing the tangential micromotion at the fracture ends under different loading forces and positions for the four internal fixation methods. A-C represent loading forces of 200N, 400N, and 600N, respectively. A, D, G, and J represent the DLP, LACP, SQAP, and CRAP groups, respectively.The deeper the red, the greater the micromotion; the lighter the blue, the smaller the micromotion.\u0026nbsp;\u003c/p\u003e\n\u003ctable id=\"Tab5\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eMaximum displacement of the pelvis under different loading modes and loading forces for the four groups of internal fixation models(mm)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eInternal fixation model\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"9\"\u003e\n \u003cp\u003emaximum displacement (mm)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003eStanding position\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003eSitting position\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003eStanding position\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e200N\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e400N\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e600N\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e200N\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e400N\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e600N\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e200N\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e400N\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e600N\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCRAP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.208\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.420\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.670\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.311\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.579\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.855\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.095\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.201\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.276\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDLP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.072\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.097\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.270\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.167\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.335\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.652\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.048\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.090\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.170\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSQAP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.078\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.212\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.174\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.328\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.495\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.042\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.099\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.151\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLACP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.090\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.099\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.136\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.178\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.377\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.567\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.067\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.121\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.192\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003ctable id=\"Tab6\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eTangential fretting of the four groups of internal fixation models under different loading methods and loading forces(mm)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eInternal fixation model\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"10\"\u003e\n \u003cp\u003eTangential micromotion(mm)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003eStanding position\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003eSitting position\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003eStanding position\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"1\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e200N\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e400N\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e600N\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e200N\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e400N\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e600N\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e200N\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e400N\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e600N\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eCRAP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.011\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.010\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eDLP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.025\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.011\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.017\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eSQAP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.027\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.012\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.018\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003eLACP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"2\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"4 Discussion","content":"\u003cp\u003eACPHTFs are complex acetabular fractures resulting from high-energy trauma, comprising approximately 7% of all acetabular fractures. With an increasingly aging population, its incidence is gradually increasing and is often accompanied by femoral head protrusion and quadrilateral surface displacement, making treatment difficult \u003csup\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]\u003c/sup\u003e. Open reduction and stable internal fixation have established themselves as the gold standard for treatment \u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eCurrently, the ideal treatment for the most complex acetabular fractures is the placement of a reconstruction plate from the inner surface of the ilium to the upper surface of the superior pubic ramus. However, single plates often fail to yield satisfactory results. Therefore, surgeons combine posterior column screws, quadrilateral screws, and other plates to reduce the risk of fixation failure \u003csup\u003e[\u003cspan additionalcitationids=\"CR29 CR30\" citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]\u003c/sup\u003e. Although these methods often yield relatively satisfactory clinical outcomes, the complex and deep anatomical structure of the acetabulum poses surgical risks, such as nerve and vascular damage and screw penetration into the hip joint \u003csup\u003e[\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]\u003c/sup\u003e. Additionally, these fixation techniques may require more surgical trauma, longer operative times, and greater blood loss. Therefore, based on the anatomical characteristics of the acetabulum, this study reports the design of a specially shaped reconstruction plate (CRAP). However, we have not yet compared the new steel with the traditional method of internal fixation. Therefore, this study used finite element analysis \u003csup\u003e[\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]\u003c/sup\u003e to compare the biomechanical characteristics and stability differences between the CRAP and traditional fixation methods, thereby providing a theoretical basis for further clinical applications.\u003c/p\u003e \u003cp\u003eFirst, the stress distributions of the new plate and its screws were compared with those of traditional plates and their corresponding screws to evaluate the stiffness of the plate structure based on stress and deformation. Stress distribution indicates the ability of the plate or screws to resist elastic deformation under force. Stress concentration may lead to deformation or even fracture of plates or screws \u003csup\u003e[\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]\u003c/sup\u003e. From the stress contour maps, it can be observed that under different loading forces, the stresses on the plates and screws were mainly concentrated near the fracture line in all four groups. This indicates that the screws and plates connecting the fracture line bear more force than other positions, which is consistent with the results of previous studies \u003csup\u003e[\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]\u003c/sup\u003e. Regarding the stiffness of the plates and screws, under the same load and position, the stress on the CRAP and its screws was greater than that on the SQAP and LACP, but less than that on the DLP. This suggests that the new plate provides sufficient strength and good mechanical stability with a more uniform stress distribution, thereby avoiding internal fixation failure. The maximum stress on the screws mainly occurred in the middle and upper parts of the screws at the screw-plate junction. Therefore, it is necessary to enhance the strength of these parts to prevent fatigue fractures. However, as the loading force increased, there was no significant difference in the maximum stress on the screws among the four groups. Although the new plate and screws bear greater stress, the maximum stress is far below the yield strength of the titanium alloy material, which can withstand a maximum stress of 795 MPa \u003csup\u003e[\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]\u003c/sup\u003e. Finally, the plates and screws in the double-column plate group bore less stress because the fixation included two plates, which could effectively distribute the stress, consistently with previous studies \u003csup\u003e[\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eNext, we assessed four internal fixation methods for tangential micromotion at the fracture site and maximum pelvic displacement. Micromotion not only promotes callus formation and accelerates fracture healing but is also an important mechanical parameter in the fracture healing process \u003csup\u003e[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/sup\u003e. Therefore, we evaluated the micromotion of the four internal fixation methods. From the tangential micromotion contour maps, there is no significant difference in tangential micromotion among the four internal fixation methods, indicating that CRAP provides sufficient biomechanical stability. The maximum displacement of the pelvis under the four internal fixation methods was compared to evaluate their stability. As is well-known, displacement also reflects the stability of internal fixation \u003csup\u003e[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]\u003c/sup\u003e. The maximum displacement of the pelvis includes both deformation and rigid-body displacement. The displacement contour maps showed that the maximum pelvic displacement was slightly larger with the CRAP than that with the other three internal fixation methods. The smallest maximum displacement was observed in the double-column plate group when treating ACPHTFs, demonstrating the best stability. However, the insertion of double-column plates requires a combined anterior-posterior approach, which has disadvantages such as greater exposure, increased risk of soft tissue damage, neurovascular injury, and longer operative time \u003csup\u003e[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]\u003c/sup\u003e. Although the maximum displacement with the CRAP is larger, previous studies have shown that under stress, there will be some relative displacement between the fracture fragments. This relative displacement in the range of 0.2\u0026ndash;1.0 mm can stimulate callus formation and promote fracture healing, whereas displacements greater than 2 mm are detrimental to fracture healing. In this study, the maximum displacement of fractures with all four internal fixation devices under different loads was less than 1 mm, indicating that they are biomechanically conducive to fracture healing \u003csup\u003e[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan additionalcitationids=\"CR41\" citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]\u003c/sup\u003e. Therefore, compared to the other three internal fixation methods, CRAP provides sufficient stability and can be considered the preferred choice for the treatment of ACPHTFs.\u003c/p\u003e \u003cp\u003eThis study is the first to conduct a finite element analysis of the lateral decubitus position, which is relevant because patients may rest in the lateral decubitus position on the affected side post-operatively. The analysis focused on stress distribution, stress peaks, and other factors when patients rest in this position post-operatively. From the stress contour maps, it can be observed that as the load increases, the new plate and its screws provide sufficient strength and biomechanical stability, preventing internal fixation failure. Micromotion and maximum displacement of the pelvis indicate that in the lateral decubitus position, the CRAP provides adequate stability. Therefore, using CRAP to treat ACPHTFs ensures that regardless of the post-operative position the patient adopts, there will be no internal fixation failure or femoral head dislocation. The CRAP is considered a safe and effective treatment option.\u003c/p\u003e \u003cp\u003eIn summary, this study demonstrated that the double-column plate group endured the least stress and provided the highest stability when treating ACPHTFs, which is consistent with previous research on acetabular fracture treatment \u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]\u003c/sup\u003e. However, double-column plate fixation has drawbacks, such as significant surgical trauma, a higher risk of neurovascular injury, and prolonged operative time \u003csup\u003e[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]\u003c/sup\u003e. Single-column plate fixation for acetabular fractures shows greater stress concentration and poorer biomechanical stability \u003csup\u003e[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]\u003c/sup\u003e. To address these limitations, we designed a novel combination of anatomical reduction plates. This fixation system benefits from the stress distribution and stability provided by the two plates and allows effective reduction and fixation of the acetabular quadrilateral, posterior column, and posterior wall fractures through a simple posterior Kocher-Langenbeck approach. This approach overcomes the difficulties associated with traditional combined anterior and posterior approaches for treating complex acetabular fractures. Furthermore, the CRAP was designed based on the acetabular morphology of Chinese patients, making it more anatomically compatible than traditional plates. This novel plate is pre-contoured to match the acetabular surface, avoiding intra-operative pre-bending and shaping, thereby significantly reducing operative time and trauma \u003csup\u003e[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn this study, the establishment of the finite element models and their parameters followed those of previous studies \u003csup\u003e[\u003c/sup\u003e45, 46] that employed similar loading and boundary conditions. Therefore, we consider this study reasonable and reliable. However, our study had some limitations. First, our study was based on computer simulations rather than real-world experiments. The finite element models used in this study were simplified and did not account for the influence of surrounding soft tissues on the fixation methods; therefore, they may not accurately reflect physiological conditions. Nevertheless, previous studies have shown that biomechanical studies based on computer simulations can still provide effective theoretical support for pelvic fracture fixation \u003csup\u003e[\u003c/sup\u003e37, 38]. Therefore, further biomechanical studies using artificial or cadaveric pelvises are needed to validate these findings. Finally, this study compared only four types of internal fixation methods for ACPHTF; other fixation methods for acetabular fractures should be compared in future research.\u003c/p\u003e"},{"header":"5 Conclusion","content":"\u003cp\u003eIn conclusion, compared to the traditional three internal fixation methods, the CRAP and its accompanying screws exhibit more uniform stress distribution and greater stiffness, providing sufficient strength and superior mechanical stability. Additionally, no significant differences were observed in interfragmentary motion among the four internal fixation methods, indicating that the CRAP can offer adequate biomechanical stability and is more favorable for fracture healing. Therefore, the CRAP fixation method presented in this study is a safe and effective option for treating ACPHTFs.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics approval and consent to participate：This study was approved by the Institutional Review Board of the Afliated Hospital of Zunyi Medical University, Zunyi, Guizho, China, Ethics number KLLY-2022-017. All subjects provided informed consent to take part in the study. All procedures were conducted according to the 1964 Declaration of Helsinki and its amendments.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest:\u0026nbsp;\u003c/strong\u003eThe authors declare that there are no conflicts of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions:\u0026nbsp;\u003c/strong\u003eChen Lin:\u0026nbsp;Participated in\u0026nbsp;study design, Data measurement, data analysis, and main contributor to writing the paper. Bao Chongshuai and\u0026nbsp;Wang Ansu: Prepared figures and tables.\u0026nbsp;Ao Jun: data analysis, and paper revision.\u0026nbsp;All the authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eThe work was supported by the Project of the Provincial and Ministerial Collaborative Innovation Center (No.39 [2020] of the Science and Technology Agency).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments:\u0026nbsp;\u003c/strong\u003eThe authors are grateful to the research participants and all the hospital staff who took an interest and helped with the study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability Statement\u003c/strong\u003e\u003cstrong\u003e:\u003c/strong\u003eThe data used and analyzed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eMauffrey, C., J. 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J Bone Joint Surg Am, 2018. 100(12): p. 1047-1054.\u003c/li\u003e\n \u003cli\u003eSawaguchi, T., T.D. Brown, H.E. Rubash, et al., Stability of acetabular fractures after internal fixation. A cadaveric study. Acta Orthop Scand, 1984. 55(6): p. 601-605.\u003c/li\u003e\n \u003cli\u003eWu, Y.D., X.H. Cai, X.M. Liu, et al., Biomechanical analysis of the acetabular buttress-plate: are complex acetabular fractures in the quadrilateral area stable after treatment with anterior construct plate-1/3 tube buttress plate fixation? Clinics (Sao Paulo), 2013. 68(7): p. 1028-1033.\u003c/li\u003e\n \u003cli\u003eAndersen, R.C., R.V. O'Toole, J.W. Nascone, et al., Modified stoppa approach for acetabular fractures with anterior and posterior column displacement: quantification of radiographic reduction and analysis of interobserver variability. J. Orthop. Trauma, 2010. 24(5): p. 271-278.\u003c/li\u003e\n \u003cli\u003eLei, J., P. Dong, Z. Li, et al., Biomechanical analysis of the fixation systems for anterior column and posterior hemi-transverse acetabular fractures. Acta Orthop. Traumatol. Turc., 2017. 51(3): p. 248-253.\u003c/li\u003e\n \u003cli\u003eWu, H., R. Shang, X. Cai, et al., Single Ilioinguinal Approach to Treat Complex Acetabular Fractures with Quadrilateral Plate Involvement: Outcomes Using a Novel Dynamic Anterior Plate-Screw System. Orthop. Surg., 2020. 12(2): p. 488-497.\u003c/li\u003e\n \u003cli\u003eLi, D., H. Ren, X. Zhang, et al., Finite Element Analysis of Channel Screw and Conventional Plate Technique in Tile B2 Pelvic Fracture. J Pers Med, 2023. 13(3).\u003c/li\u003e\n \u003cli\u003eZhang, D., N. Liu, Y. Chen, et al., Microstructure Evolution and Mechanical Properties of PM-Ti43Al9V0.3Y Alloy. Materials (Basel), 2020. 13(1).\u003c/li\u003e\n \u003cli\u003eBrolin, K. and P. Halldin, Development of a finite element model of the upper cervical spine and a parameter study of ligament characteristics. 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Pallottino, et al., Operative treatment of transverse acetabular fractures: is it really necessary to fix both columns? Int. J. Med. Sci., 2009. 6(4): p. 192-199.\u003c/li\u003e\n \u003cli\u003eSteiner, M., L. Claes, A. Ignatius, et al., Numerical simulation of callus healing for optimization of fracture fixation stiffness. PLoS One, 2014. 9(7): p. e101370.\u003c/li\u003e\n \u003cli\u003eShi Jinyou, Xiao Yuzhou, Wu Min, and Guan Jianzhong (2021). Study on the Nature of Micromotion and Biomechanical Staging of Fracture Healing. Chinese Journal of Reparative and Reconstructive Surgery.35(09)\u003cstrong\u003e,\u003c/strong\u003e 1205-1211.\u003c/li\u003e\n \u003cli\u003eEpari, D.R., R. Gurung, L. Hofmann-Fliri, et al., Biphasic plating improves the mechanical performance of locked plating for distal femur fractures. J. Biomech., 2021. 115: p. 110192.\u003c/li\u003e\n \u003cli\u003eTosounidis, T.H. and P.V. Giannoudis, What is new in acetabular fracture fixation? Injury, 2015. 46(11): p. 2089-2092.\u003c/li\u003e\n \u003cli\u003eCahueque, M., M. Martínez, A. Cobar, et al., Early reduction of acetabular fractures decreases the risk of post-traumatic hip osteoarthritis? J Clin Orthop Trauma, 2017. 8(4): p. 320-326.\u003c/li\u003e\n \u003cli\u003eAnderson, A.E., C.L. Peters, B.D. Tuttle, et al., Subject-specific finite element model of the pelvis: development, validation and sensitivity studies. #N/A, 2005. 127(3): p. 364-373.\u003c/li\u003e\n \u003cli\u003eDalstra, M. and R. Huiskes, Load transfer across the pelvic bone. J. Biomech., 1995. 28(6): p. 715-724.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"combined reduction anatomical plate, acetabular fractures, finite element analysis, internal fixation, Biomechanics","lastPublishedDoi":"10.21203/rs.3.rs-4964573/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4964573/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cem\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e\u003c/em\u003e Acetabularanterior column and posterior hemi-transverse fractures pose a significant challenge for orthopaedic surgeons. Traditional treatment methods are associated with high rates of post-operative complications and lengthy surgical procedures. To enhance treatment efficacy, this study developed a novel internal fixation device called the Combined Reduction Anatomical Plate (CRAP) and conducted a finite element analysis to compare its biomechanical properties to those of traditional internal fixation methods.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eMethods: \u003c/strong\u003e\u003c/em\u003eA standard finite element model of an anterior column and posterior hemi-transverse fracture of the acetabulum was established using finite element software. Subsequently, four different internal fixation devices were applied: CRAP, double-column locking plates (DLP), supra-pectineal quadrilateral anatomical plate (SQAP), and iliositus + anterior column plate (LACP). After determining the boundary conditions and material properties, the model was simulated in three different body positions (standing, sitting, and lying on the affected side) and subjected to vertical downward forces of 200 N, 400 N, and 600 N. Subsequently, the stress distribution and peak values among the four fixation methods were analyzed, and the maximum pelvic displacement and fracture fragment displacement were evaluated.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eResults: \u003c/strong\u003e\u003c/em\u003eIn this study, the CRAP maximum stress on the steel plate and screws was 159.540 N, 160.540 N, 157.050 N, 177.330 N, 64.756 N, and 30.003 N, which was less than that of the SQAP and LACP and greater than that of the DLP. The maximum tangential micromotion of the CRAP was only 0.016 mm, and the maximum displacement of the pelvis was 0.855 mm. The results showed that the new type of plate developed and designed in this study exhibited a relatively uniform stress distribution and high stiffness, providing sufficient strength. However, the four groups showed no obvious difference in tangential fretting.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e\u003c/em\u003e Compared with the other three fixation methods, the newly designed sectional anatomical reduction plate and screws showed a uniform stress distribution, greater rigidity, sufficient strength, and improved mechanical stability. The CRAP can therefore provide sufficient biomechanical stability and help fracture healing.\u003c/p\u003e","manuscriptTitle":"A new combined reduction anatomical plate for the treatment of acetabular anterior column and posterior hemi-transverse fractures: a finite element analysis study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-10-18 10:21:11","doi":"10.21203/rs.3.rs-4964573/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"12a8dbba-61a9-48f1-b288-dfde340ed818","owner":[],"postedDate":"October 18th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-09-23T05:23:41+00:00","versionOfRecord":[],"versionCreatedAt":"2024-10-18 10:21:11","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4964573","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4964573","identity":"rs-4964573","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}