{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T15:21:22Z","timestamp":1784647282828,"version":"3.55.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"vor","delay-in-days":47,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Startup Fund for Scientific Research, Fujian Medical University","award":["Grant No. 2020QH1315"],"award-info":[{"award-number":["Grant No. 2020QH1315"]}]},{"name":"Science and Technology Program of Fujian Provincial Health Commission","award":["Grant No. 2021QNB013"],"award-info":[{"award-number":["Grant No. 2021QNB013"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This study aimed to evaluate the biomechanical performance of different sacroiliac screw fixation strategies for posterior pelvic ring injuries in older adults with fragility fractures of the pelvis. A finite element model was created using the pelvis of an older woman with combined anterior and posterior ring injuries, simulating a unilateral pubic rami fracture and a Denis zone I sacral fracture. A subcutaneous internal fixator (INFIX) system was used to support the anterior pelvic ring. Percutaneous sacroiliac screws of different lengths and fixation levels were used to create six posterior fixation configurations. The peak von Mises stress within the INFIX system remained below 4\u00a0MPa across all configurations, whereas the maximum displacement at the pubic fracture site was &lt;\u20090.04\u00a0mm. Among posterior constructs, the dual-segment long screw configuration showed the lowest sacral fracture displacement (0.02\u00a0mm) and the highest screw stress (28.66\u00a0MPa). Compared with single-level fixation, constructs with both S1 and S2 fixation demonstrated less fracture displacement and superior load distribution patterns. Furthermore, compared with short screws, long screws exhibited distinct load-sharing features, suggesting improved stress transfer through the posterior pelvic ring. In conclusion, dual-segment sacroiliac screw fixation\u2014particularly using long trans-iliac\u2013trans-sacral screws spanning both S1 and S2 levels\u2014provided improved fracture stability and more advantageous load-sharing behavior in this simulation setting, both in the osteoporotic finite element model and under static, symmetric loading conditions.<\/jats:p>","DOI":"10.1038\/s41598-026-45149-1","type":"journal-article","created":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T09:54:27Z","timestamp":1774000467000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Finite element analysis of sacral fixation strategies for fragility fractures of the pelvis"],"prefix":"10.1038","volume":"16","author":[{"given":"Shenghong","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Libao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changhui","family":"Xue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenwu","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanchen","family":"Gong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengyi","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linfeng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,20]]},"reference":[{"key":"45149_CR1","doi-asserted-by":"publisher","unstructured":"Andrich, S. et al. Epidemiology of Pelvic Fractures in Germany: Considerably High Incidence Rates among Older People. Plos One. 10 https:\/\/doi.org\/10.1371\/journal.pone.0139078 (2015).","DOI":"10.1371\/journal.pone.0139078"},{"key":"45149_CR2","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1359\/jbmr.2002.17.4.716","volume":"17","author":"D Felsenberg","year":"2002","unstructured":"Felsenberg, D. et al. Incidence of vertebral fracture in Europe: Results from the European Prospective Osteoporosis Study (EPOS). J. Bone Miner. Res. 17, 716\u2013724 (2002).","journal-title":"J. Bone Miner. Res."},{"key":"45149_CR3","doi-asserted-by":"publisher","unstructured":"Roigk, P. et al. Older patients with vertebral and pelvic fractures: Study protocol of a clinical cohort. Plos One. 19 https:\/\/doi.org\/10.1371\/journal.pone.0306727 (2024).","DOI":"10.1371\/journal.pone.0306727"},{"key":"45149_CR4","doi-asserted-by":"publisher","unstructured":"Graul, I. et al. Triangular Screw Placement to Treat Dysmorphic Sacral Fragility Fractures in Osteoporotic Bone Results in an Equivalent Stability to Cement-Augmented Sacroiliac Screws-A Biomechanical Cadaver Study. J. Clin. Med. 14 https:\/\/doi.org\/10.3390\/jcm14051497 (2025).","DOI":"10.3390\/jcm14051497"},{"key":"45149_CR5","doi-asserted-by":"publisher","unstructured":"Zong, Y. Q., Li, J. W., Li, Z. Y. & Wang, W. Z. Minimally invasive surgery and conservative treatment achieve similar clinical outcomes in patients with type II fragility fractures of the pelvis. J. Orthop. Surg, Res. 20 https:\/\/doi.org\/10.1186\/s13018-025-05581-x (2025).","DOI":"10.1186\/s13018-025-05581-x"},{"key":"45149_CR6","doi-asserted-by":"publisher","unstructured":"Yang, K. W., Xiang, F. F., Ye, J. W. & Yang, Y. K. A retrospective analysis of minimally invasive internal fixation versus nonoperative conservative management of pelvic ring fragility fractures and the elderly. J. Orthop. Surg, Res. 18 https:\/\/doi.org\/10.1186\/s13018-023-03591-1 (2023).","DOI":"10.1186\/s13018-023-03591-1"},{"key":"45149_CR7","doi-asserted-by":"publisher","first-page":"871","DOI":"10.1007\/s00132-021-04158-w","volume":"50","author":"F Faber","year":"2021","unstructured":"Faber, F. Osteoporotic fractures of the pelvic ring and their minimally invasive treatment options. Orthopade 50, 871\u2013882. https:\/\/doi.org\/10.1007\/s00132-021-04158-w (2021).","journal-title":"Orthopade"},{"key":"45149_CR8","doi-asserted-by":"publisher","unstructured":"Kramer, A. et al. Retrospective evaluation of percutaneous 3D-navigated screw fixation for fragility fractures of the sacrum: technical notes and four-year experience. Sci. Rep. 13 https:\/\/doi.org\/10.1038\/s41598-023-39165-8 (2023).","DOI":"10.1038\/s41598-023-39165-8"},{"key":"45149_CR9","doi-asserted-by":"publisher","unstructured":"Hartensuer, R. et al. Effect and Feasibility of Percutaneous SI-Screw with and without Augmentation-A 15-Year Retrospective Analysis on over 640 Screws. J. Clin. Med. 9 https:\/\/doi.org\/10.3390\/jcm9082660 (2020).","DOI":"10.3390\/jcm9082660"},{"key":"45149_CR10","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1016\/j.otsr.2013.03.023","volume":"99","author":"Y Zhao","year":"2013","unstructured":"Zhao, Y. et al. Mechanical comparison between lengthened and short sacroiliac screws in sacral fracture fixation: a finite element analysis. Orthop. Traumatol. Surg. Res. 99, 601\u2013606. https:\/\/doi.org\/10.1016\/j.otsr.2013.03.023 (2013).","journal-title":"Orthop. Traumatol. Surg. Res."},{"key":"45149_CR11","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1016\/j.injury.2011.12.023","volume":"43","author":"Y Zhao","year":"2012","unstructured":"Zhao, Y. et al. 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Written informed consent to participate in this study and for the publication of the resulting data was obtained from the patient.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The patient provided consent for publication.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}],"article-number":"14318"}}