# Novel 3D-navigated screw corridors for posterior pelvic ring stabilization: a finite element analysis

**Authors:** Eftychios Bolierakis, Maximilian Praster, Hatem Alabdulrahman, Ulf Krister Hofmann, Christian Herren, Roman Michalik, Michel Teuben, Hans-Christoph Pape, Frank Hildebrand, Till Berk

PMC · DOI: 10.1007/s00068-025-03053-9 · European Journal of Trauma and Emergency Surgery · 2026-01-13

## TL;DR

This study explores new 3D-guided screw paths for stabilizing the pelvis, showing potential biomechanical benefits over traditional methods.

## Contribution

The paper introduces novel 3D-navigated screw corridors for posterior pelvic stabilization using finite element analysis.

## Key findings

- Conventional transsacral screws showed the most uniform stress distribution and lowest peak stresses.
- Variant III of the novel configurations achieved favorable compressive load transfer and lower shear stresses.
- Variant IV showed the highest overall stress, while Variant V had intermediate stress behavior.

## Abstract

Posterior pelvic ring stabilization is technically demanding due to the complex local anatomy and limited osseous corridors. Advances in 3D navigation may allow for new screw trajectories previously infeasible with conventional fluoroscopy.

A finite element model (FE) of a pelvis (Synbone LSS4060/Hard®) was developed, simulating seven screw configurations, including three novel oblique navigated pathways (Variants III–V). A 600 N vertical load was applied to simulate bipedal stance. Stress distribution and von Mises stresses were compared among configurations.

Conventional transsacral screws (Variants I–II) demonstrated the most uniform stress distribution and lowest peak stresses (7.17 MPa). Among novel configurations, Variant III achieved favorable compressive load transfer and lower shear stresses. Variant IV exhibited the highest overall stress (17.80 MPa), while Variant V demonstrated intermediate behavior.

The proposed 3D-navigated oblique screw pathways are anatomically feasible and may offer biomechanical advantages under certain conditions. These findings support further validation using cadaveric and clinical studies.

## Full-text entities

- **Mutations:** A 600 N

## Full text

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## Figures

13 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12799661/full.md

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Source: https://tomesphere.com/paper/PMC12799661