{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T11:47:51Z","timestamp":1762256871130,"version":"build-2065373602"},"reference-count":30,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Stiftung Universit\u00e4t Medizin\/RWTH Aachen, Start-Program","award":["380957"],"award-info":[{"award-number":["380957"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>(1) Background: This study proposes investigating the biomechanical stability of a novel 6-hole L-shaped plate for symphyseal fixation, which allows for reduction and stability in two planes. The results of the novel plate are compared to the standard plate; (2) Methods: The novel plate fixation and the standard 6-hole pubic symphyseal plate were tested with a pelvis model simulating an APC III injury. Each group of 10 pelves was subjected to a cyclic biomechanical single-leg-stance test for 30,000 cycles simulating partial bearing loading at 1 Hz, followed by a maximum load-to-failure test. The stiffness and displacement were evaluated and analyzed; (3) Results: Stiffness measurements during cyclic loading revealed no significant differences between the groups (p = 0.514). The cumulative plastic deformation was significantly lower in the novel plate group (p = 0.005). Load-to-failure testing demonstrated that both constructs exhibited similar ultimate strength, with no significant difference in the mean of maximum force between the novel (400.61 \u00b1 44.65 N) and reference (433.02 \u00b1 87.60 N) groups (p = 0.804); (4) Conclusions: The novel plate provides comparable biomechanical stability to the reference plate under the tested cyclic loading conditions, suggesting that it could be a viable alternative to the existing standard. However, further research is necessary to understand the clinical outcomes and long-term impacts.<\/jats:p>","DOI":"10.3390\/life15111708","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T11:11:16Z","timestamp":1762254676000},"page":"1708","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["An Innovative Pubic Symphyseal Plate for the Treatment of Open-Book Injury: A Biomechanical Feasibility Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3341-3605","authenticated-orcid":false,"given":"Marx","family":"Ribeiro","sequence":"first","affiliation":[{"name":"Department for Trauma and Reconstructive Surgery, University Hospital Halle (Saale), Ernst-Grube-Stra\u00dfe 40, 06120 Halle (Saale), Germany"},{"name":"Department for Trauma and Reconstructive Surgery, BG Hospital Bergmannstrost Halle (Saale), Merseburger Str. 165, 06112 Halle (Saale), Germany"},{"name":"Department of Mechanical Engineering, Federal University of Santa Catarina, R. Lauro Linhares 1850, Florianopolis 88070-260, Brazil"},{"name":"Department for Orthopedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5039-9385","authenticated-orcid":false,"given":"Qun","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department for Orthopedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9582-1810","authenticated-orcid":false,"given":"Till","family":"Berk","sequence":"additional","affiliation":[{"name":"Department for Orthopedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0332-1750","authenticated-orcid":false,"given":"Luis Fernando","family":"Nicolini","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Federal University of Santa Maria, Av. Roraima 1000, Santa Maria 97105-900, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9542-8900","authenticated-orcid":false,"given":"Eftychios","family":"Bolierakis","sequence":"additional","affiliation":[{"name":"Department for Orthopedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7162-6153","authenticated-orcid":false,"given":"Klemens","family":"Horst","sequence":"additional","affiliation":[{"name":"Department for Orthopedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2856-4804","authenticated-orcid":false,"given":"Johannes","family":"Greven","sequence":"additional","affiliation":[{"name":"Department for Thorax Surgery, University Hospital RWTH Aachen, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8020-0788","authenticated-orcid":false,"given":"Philipp","family":"Kobbe","sequence":"additional","affiliation":[{"name":"Department for Trauma and Reconstructive Surgery, University Hospital Halle (Saale), Ernst-Grube-Stra\u00dfe 40, 06120 Halle (Saale), Germany"},{"name":"Department for Trauma and Reconstructive Surgery, BG Hospital Bergmannstrost Halle (Saale), Merseburger Str. 165, 06112 Halle (Saale), Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8477-4884","authenticated-orcid":false,"given":"J\u00f6rg","family":"Eschweiler","sequence":"additional","affiliation":[{"name":"Department for Trauma and Reconstructive Surgery, University Hospital Halle (Saale), Ernst-Grube-Stra\u00dfe 40, 06120 Halle (Saale), Germany"},{"name":"Department for Trauma and Reconstructive Surgery, BG Hospital Bergmannstrost Halle (Saale), Merseburger Str. 165, 06112 Halle (Saale), Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7729-9838","authenticated-orcid":false,"given":"Frank","family":"Hildebrand","sequence":"additional","affiliation":[{"name":"Department for Orthopedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hatem","family":"Alabdulrahman","sequence":"additional","affiliation":[{"name":"Department for Orthopedics, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstra\u00dfe 30, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,4]]},"reference":[{"key":"ref_1","first-page":"e63669","article-title":"Comprehensive Orthopedic Management of an Open-Book Pelvic Fracture: A Multidisciplinary Approach in Trauma Care","volume":"16","author":"Saleh","year":"2024","journal-title":"Cureus"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1097\/00005373-199007000-00015","article-title":"Pelvic ring disruptions: Effective classification system and treatment protocols","volume":"30","author":"Burgess","year":"1990","journal-title":"J. Trauma."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s13017-017-0117-6","article-title":"Pelvic trauma: WSES classification and guidelines","volume":"12","author":"Coccolini","year":"2017","journal-title":"World J. Emerg. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"S18","DOI":"10.1097\/BOT.0000000000001252","article-title":"Indications for Open Reduction Internal Fixation of Anterior Pelvic Ring Disruptions","volume":"32","author":"Wright","year":"2018","journal-title":"J. Orthop. Trauma."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2665","DOI":"10.1007\/s00402-024-05390-7","article-title":"Motion preservation for open book injuries of the pubic symphysis\u2014A biomechanical cadaver study","volume":"144","author":"Baur","year":"2024","journal-title":"Arch. Orthop. Trauma. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"667","DOI":"10.5435\/JAAOS-D-17-00839","article-title":"Fixation of Anterior Pelvic Ring Injuries","volume":"27","author":"Wojahn","year":"2019","journal-title":"J. Am. Acad. Orthop. Surg."},{"doi-asserted-by":"crossref","unstructured":"Collinge, C., Archdeacon, M.T., Dulaney-Cripe, E., and Moed, B.R. (2012). Radiographic Changes of Implant Failure After Plating for Pubic Symphysis Diastasis: An Underappreciated Reality?. Clinical Orthopaedics and Related Research, Springer New York LLC.","key":"ref_7","DOI":"10.1007\/s11999-012-2340-5"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1965","DOI":"10.1007\/s00402-022-04411-7","article-title":"The radiographic outcome after plating for pubic symphysis diastasis: Does it matter clinically?","volume":"143","author":"Tseng","year":"2023","journal-title":"Arch. Orthop. Trauma. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.injury.2012.09.023","article-title":"Reduction and fixation capabilities of different plate designs for pubic symphysis disruption: A biomechanical comparison","volume":"44","author":"Pizanis","year":"2013","journal-title":"Injury"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1007\/s00264-018-3963-2","article-title":"Conventional plate fixation method versus pre-operative virtual simulation and three-dimensional printing-assisted contoured plate fixation method in the treatment of anterior pelvic ring fracture","volume":"43","author":"Hung","year":"2019","journal-title":"Int. Orthop."},{"doi-asserted-by":"crossref","unstructured":"Wang, C., Chen, Y., Wang, L., Wang, D., Gu, C., Lin, X., Liu, H., Chen, J., Wen, X., and Liu, Y. (2020). Three-dimensional printing of patient-specific plates for the treatment of acetabular fractures involving quadrilateral plate disruption. BMC Musculoskelet. Disord., 21.","key":"ref_11","DOI":"10.1186\/s12891-020-03370-7"},{"doi-asserted-by":"crossref","unstructured":"Sass, J.O., Saemann, M., Kebbach, M., Soodmand, E., Wree, A., Bader, R., and Kluess, D. (2024). The Morphology of the Femur Influences the Fracture Risk during Stumbling and Falls on the Hip\u2014A Computational Biomechanical Study. Life, 14.","key":"ref_12","DOI":"10.3390\/life14070841"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1186\/s13018-022-03078-5","article-title":"Biomechanical evaluation of seven fixation methods to treat pubic symphysis diastasis using finite element analysis","volume":"17","author":"Zheng","year":"2022","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"102933","DOI":"10.1016\/j.rineng.2024.102933","article-title":"The effects of graphene oxide nanoparticles on the mechanical and thermal properties of polyurethane\/polycaprolactone nanocomposites; a molecular dynamics approach","volume":"24","author":"Heydari","year":"2024","journal-title":"Results Eng."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1007\/s00068-015-0529-5","article-title":"Symphyseal internal rod fixation versus standard plate fixation for open book pelvic ring injuries: A biomechanical study","volume":"42","author":"Osterhoff","year":"2016","journal-title":"Eur. J. Trauma Emerg. Surg."},{"doi-asserted-by":"crossref","unstructured":"Jordan, M.C., J\u00e4ckle, V., Scheidt, S., Gilbert, F., H\u00f6lscher-Doht, S., Erg\u00fcn, S., Meffert, R.H., and Heintel, T.M. (2021). Trans-obturator cable fixation of open book pelvic injuries. Sci. Rep., 11.","key":"ref_16","DOI":"10.1038\/s41598-021-92755-2"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1097\/BOT.0000000000002381","article-title":"Biomechanical Comparison of 4 Transsacral Fixation Constructs in a Type 61C, Zone II Pelvic Fracture Model","volume":"36","author":"Bradley","year":"2022","journal-title":"J. Orthop. Trauma."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1097\/BOT.0b013e3182781102","article-title":"Biomechanical Comparison of Standard Iliosacral Screw Fixation to Transsacral Locked Screw Fixation in a Type C Zone II Pelvic Fracture Model","volume":"27","author":"Tabaie","year":"2013","journal-title":"J. Orthop. Trauma."},{"doi-asserted-by":"crossref","unstructured":"Brandes, L.L., Nicolini, L.F., Greven, J., Lichte, P., Stopinski, T.T., Sattler, M., Hildebrand, F., and Pishnamaz, M. (2021). Biomechanical Performance of BoneHelix\u00ae Compared with Elastic Stable Intramedullary Nailing (ESIN) in a Pediatric Tibia Fracture Model. Life, 11.","key":"ref_19","DOI":"10.3390\/life11111189"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1007\/s00068-016-0661-x","article-title":"Biomechanical comparison of locked versus non-locked symphyseal plating of unstable pelvic ring injuries","volume":"44","author":"Godinsky","year":"2018","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2569","DOI":"10.1007\/s00068-023-02333-6","article-title":"Substitutional semi-rigid osteosynthesis technique for treatment of unstable pubic symphysis injuries: A biomechanical study","volume":"49","author":"Berk","year":"2023","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1055\/s-0039-1697973","article-title":"Placas anteriores s\u00e3o mais efetivas do que parafusos iliossacrais na fixa\u00e7\u00e3o da articula\u00e7\u00e3o sacroil\u00edaca? Estudo Biomec\u00e2nico","volume":"55","author":"Goldsztajn","year":"2020","journal-title":"Rev. Bras. Ortop."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1097\/00005131-199711000-00008","article-title":"Stability of Open-Book Pelvic Fractures Using a New Biomechanical Model of Single-Limb Stance","volume":"11","author":"MacAvoy","year":"1997","journal-title":"J. Orthop. Trauma."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/1749-799X-7-31","article-title":"Biomechanical stability of a supra-acetabular pedicle screw Internal Fixation device (INFIX) vs External Fixation and plates for vertically unstable pelvic fractures","volume":"7","author":"Vigdorchik","year":"2012","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e2207","DOI":"10.1097\/MD.0000000000002207","article-title":"Comparison of biomechanical characteristics and pelvic ring stability using different fixation methods to treat pubic symphysis diastasis a finite element study","volume":"94","author":"Yao","year":"2015","journal-title":"Medicine"},{"doi-asserted-by":"crossref","unstructured":"Stuby, F.M., Lenz, M., Doebele, S., Agarwal, Y., Skulev, H., Ochs, B.G., Zwingmann, J., and Gueorguiev, B. (2017). Symphyseal fixation in open book injuries cannot fully compensate anterior SI joint injury\u2014A biomechanical study in a two-leg alternating load model. PLoS ONE, 12.","key":"ref_26","DOI":"10.1371\/journal.pone.0184000"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/0020-1383(95)92180-I","article-title":"Effects of method of internal fixation of symphyseal disruptions on stability of the pelvic ring","volume":"26","author":"Varga","year":"1995","journal-title":"Injury"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"101107","DOI":"10.1016\/j.tcr.2024.101107","article-title":"Pubic symphysis tethering technique under endoscopic approach for treatment of pelvic open-book injury: A cadaver study","volume":"54","author":"Moreau","year":"2024","journal-title":"Trauma. Case Rep."},{"key":"ref_29","first-page":"2235","article-title":"Novel minimally invasive tape suture osteosynthesis for instabilities of the pubic symphysis: A biomechanical study","volume":"142","author":"Schwaabe","year":"2022","journal-title":"Arch. Orthop. Trauma. Surg."},{"key":"ref_30","first-page":"3111","article-title":"Tape suture constructs for instabilities of the pubic symphysis: Is the idea of motion preservation a suitable treatment option? A cadaver study","volume":"143","author":"Schwaabe","year":"2023","journal-title":"Arch. Orthop. Trauma. Surg."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/15\/11\/1708\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T11:41:17Z","timestamp":1762256477000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/15\/11\/1708"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,4]]},"references-count":30,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["life15111708"],"URL":"https:\/\/doi.org\/10.3390\/life15111708","relation":{},"ISSN":["2075-1729"],"issn-type":[{"type":"electronic","value":"2075-1729"}],"subject":[],"published":{"date-parts":[[2025,11,4]]}}}