不穩定型骨盆骨折為人體骨折中較不易處理的，此類型骨折常會伴隨骨盆腔內器官受損或失血性休克，而造成較高的發病率與致死率。在過去的相關研究中，不同類型的固定系統已被用於治療不穩定型骨盆骨折，包括：骨外固定器、骨板、薦骨鋼棒、髂薦螺絲、具預張力彎曲鋼棒，然而，上述的骨盆骨折固定系統主要還是藉由臨床研究進行探討，且多數的臨床研究僅針對其中一種骨盆骨折固定系統進行評估，目前僅有少數的研究比較不同骨盆骨折固定系統的生物力學性能，此外，先前的研究已建立三維有限元素模型，以探討骨盆骨折固定系統的生物力學結果，但是，數值模型僅考慮薦骨與骨盆骨，目前沒有任何研究嘗試完整的脊椎-骨盆-股骨骨骼系統模型。因此，本研究的目的為分析與探討三種骨盆骨折固定術，對於不穩定型骨盆骨折治療的生物力學研究。
本研究使用 ANSYS Workbench 14.5 建立三維非線性脊椎-骨盆-股骨骨骼系統模型，以分析不同骨盆骨折固定系統的生物力學性能，此外，亦使用生物力學測試法進行數值分析結果的驗證。本研究將針對三種骨盆骨折內固定器進行評估與討論，包括：後方髂薦螺絲、薦骨鋼棒、鎖定式骨板，藉由骨折固定穩定度、骨盆骨應力、植入物強度的結果，以探討不同骨盆骨折固定系統的優缺點。
本研究結果得知，「後方髂薦螺絲固定」相較於「薦骨鋼棒固定」與「鎖定式骨板固定」具有較佳的骨折固定穩定度，此外「鎖定式骨板固定」於骨盆應力與植入物應力有較高的應力集中結果，此易造成骨盆二次骨折或植入物破壞之風險，本研究建立之三維骨骼系統模型，可有效的評估正常情況、骨折情況與不同骨折固定情況之生物力學結果，我們期望研究計畫的成果可給予臨床醫師相關手術的參考依據，同時幫助臨床醫師更了解骨盆骨折固定系統的生物力學。

Unstable pelvic fracture represents a severe injury associated with high morbidity and mortality. In the past, several types of fixators were used to treat this unstable fracture, including external fixators, plates, sacral bars, iliosacral screws, and pre-tensed curved bar. However, the biomechanical performances of the above fixation techniques were mainly evaluated according to the outcomes of clinical applications, and only one of the fixation techniques was selected and evaluated. To our knowledge, there were few studies to analyze and compare the biomechanical performances of different pelvic fixation techniques. In addition, the past studies had investigated one of the fixation techniques by using finite element methods. However, there has been no study that investigated the biomechanical performances of the fixation techniques by using 3D nonlinear finite element models of spine-pelvis-femur complex. Thus, the purpose of this study was to analyze and investigate the biomechanical performances of different pelvic fixation techniques for the treatment of unstable pelvic fracture.
Three-dimensional nonlinear finite element models of spine-pelvis-femur complex were developed to investigate the biomechanical performances of different pelvic fixation techniques by using ANSYS Workbench 14.5. Concurrently, the biomechanical experiment was developed to validate the numerical results. In this study, three types of the pelvic fixators were evaluated and discussed, including posterior iliosacral screws, sacral bars, and locking compression plate. The fixation stability, pelvic stress, and implant strength were obtained and used to evaluate the strength and limitation of each fixation technique.
The results of this study showed that the posterior iliosacral screws had better fixation stability compared with the sacral bars and the locking compression plate. Additionally, the locking compression plate revealed higher stress concentration effects on the pelvis and the implants compared with others. We hope that the outcomes of this study could directly provide the surgical suggestion to orthopedic surgeons and help them to understand the biomechanics of different pelvic fixation techniques.

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