{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T02:11:35Z","timestamp":1768356695170,"version":"3.49.0"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Science & Technology Innovation Development Project of Yantai City, China","award":["No.2021MSGY049&NO.2021YD045&2022YD048"],"award-info":[{"award-number":["No.2021MSGY049&NO.2021YD045&2022YD048"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["No. 81641171 & No. 81301553"],"award-info":[{"award-number":["No. 81641171 & No. 81301553"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Shandong Provincial Key R&D Program of China","award":["No. 2018GSF118064"],"award-info":[{"award-number":["No. 2018GSF118064"]}]},{"name":"Medical and Health Technology Development Program of Shandong Province, China","award":["No.202104070173&202404070931"],"award-info":[{"award-number":["No.202104070173&202404070931"]}]},{"DOI":"10.13039\/501100004307","name":"Distinguished Middle-Aged and Young Scientist Encourage and Reward Foundation of Shandong Province","doi-asserted-by":"publisher","award":["No. BS2013SF015"],"award-info":[{"award-number":["No. BS2013SF015"]}],"id":[{"id":"10.13039\/501100004307","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Binzhou Medical University \u201cClinical+X\u201d Scientific and Technological Innovation Project","award":["No. BY2021LCX32"],"award-info":[{"award-number":["No. BY2021LCX32"]}]},{"name":"Binzhou Medical University \u201cClinical+X\u201d","award":["2025CMX1001"],"award-info":[{"award-number":["2025CMX1001"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to optimize iliolumbar fixation strategies for unilateral vertical sacral fractures via finite element analysis, by comparing stability, implant stress, and lumbar mobility to identify the optimal clinical option.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A finite element model of the pelvis and L3-L5 lumbar spine was constructed to simulate four fixation models (L4L5IS, L5S1IS, L5IS, S1IS) under a 600\u2009N vertical load. Sacral vertical displacement, implant stress, and fracture line separation were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Double-segment fixation (L4\u2009+\u2009L5\u2009+\u2009iliac screw and L5\u2009+\u2009S1\u2009+\u2009iliac screw) demonstrated superior sacral stability compared to single-segment fixation (L5\u2009+\u2009iliac screw and S1\u2009+\u2009iliac screw). The L5\u2009+\u2009S1\u2009+\u2009iliac screw configuration achieved the best balance of stability and lumbar mobility. Stress concentrations were primarily observed at iliac screw connectors, but all models remained within safe mechanical limits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Double-segment fixation, particularly the L5\u2009+\u2009S1\u2009+\u2009iliac screw model, is recommended for optimal sacral stability. For cases with compromised S1 pedicles, L4\u2009+\u2009L5\u2009+\u2009iliac screw fixation is a reliable alternative. Short-segment fixation is viable when prioritizing lumbar mobility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0339705","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T18:25:20Z","timestamp":1768328720000},"page":"e0339705","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Biomechanical optimization of iliolumbar fixation strategies for unilateral vertical sacral fractures: Prioritizing stability-mobility balance via finite element 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