scholarly journals Comparison between external locking plate fixation and conventional external fixation for extraarticular proximal tibial fractures: a finite element analysis

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Dejan Blažević ◽  
Janoš Kodvanj ◽  
Petra Adamović ◽  
Dinko Vidović ◽  
Zlatko Trobonjača ◽  
...  
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
External Fixation ◽  
Tibial Fracture ◽  
Locking Plate ◽  
Plate Fixation ◽  
Proximal Tibial Fracture ◽  
Locking Plate Fixation ◽  
Element Analysis ◽  
Maximum Stiffness

Abstract Background Good clinical outcomes for locking plates as an external fixator to treat tibial fractures have been reported. However, external locking plate fixation is still generally rarely performed. This study aimed to compare the stability of an external locking plate fixator with that of a conventional external fixator for extraarticular proximal tibial fractures using finite element analysis. Methods Three models were constructed: (1) external locking plate fixation of proximal tibial fracture with lateral proximal tibial locking plate and 5-mm screws (ELP), (2) conventional external fixation of proximal tibial fracture with an 11-mm rod and 5-mm Schanz screws (EF-11), and (3) conventional external fixation of a proximal tibial fracture with a 7-mm rod and 5-mm Schanz screws (EF-7). The stress distribution, displacement at the fracture gap, and stiffness of the three finite element models at 30-, 40-, 50-, and 60-mm plate–rod offsets from the lateral surface of the lateral condyle of the tibia were determined. Results The conventional external fixator showed higher stiffness than the external locking plate fixator. In all models, the stiffness decreased as the distance of the plate–rod from the bone surface increased. The maximum stiffness was 121.06 N/mm in the EF-11 model with 30-mm tibia–rod offset. In the EF-7 model group, the maximum stiffness was 40.00 N/mm in the model with 30-mm tibia–rod offset. In the ELP model group, the maximum stiffness was 35.79 N/mm in the model with 30-mm tibia–plate offset. Conclusions Finite element analysis indicated that external locking plate fixation is more flexible than conventional external fixation and can influence secondary bone healing. External locking plate fixation requires the placement of the plate as close as possible to the skin, which allows for a low-profile design because the increased distance from the plate to the bone can be too flexible for bone healing. Further experimental mechanical model tests are necessary to validate these finite element models, and further biological analysis is necessary to evaluate the effect of external locking plate fixation on fracture healing.

Comparison between External Locking Plate Fixation and Conventional External Fixation for Extraarticular Proximal Tibial Fractures: A Finite Element Analysis

2021 ◽  
Author(s):  
Dejan Blažević ◽  
Janoš Kodvanj ◽  
Petra Adamović ◽  
Dinko Vidović ◽  
Zlatko Trobonjača ◽  
...  
Keyword(s):  
Finite Element ◽  
External Fixation ◽  
External Fixator ◽  
Tibial Fracture ◽  
Locking Plate ◽  
Plate Fixation ◽  
Tibial Fractures ◽  
Proximal Tibial Fracture ◽  
Locking Plate Fixation ◽  
Maximum Stiffness

Abstract BackgroundGood clinical outcomes for locking plates as an external fixator to treat tibial fractures have been reported. However, external locking plate fixation is still generally rarely performed. This study aimed to compare the stability of external locking plate fixator with that of conventional external fixator for extraarticular proximal tibial fractures, using finite element analysis. MethodsThree models were constructed: (1) external locking plating of proximal tibial fracture with lateral proximal tibial locking plate and 5-mm screws (ELP), (2) conventional external fixation of proximal tibial fracture with an 11-mm rod and 5-mm Schanz screws (EF-11), and (3) conventional external fixation of proximal tibial fracture with a 7-mm rod and 5-mm Schanz screws (EF-7). The stress distribution, displacement at the fracture gap, and stiffness of the three finite element models at 30-, 40-, 50-, and 60-mm plate–rod offset from the lateral surface of the lateral condyle of the tibia were determined. ResultsThe conventional external fixator showed higher stiffness than did the external locking plate fixator. In all models, the stiffness decreased as the distance of the plate–rod from the bone surface increased. The maximum stiffness was 121.06 N/mm in the EF-11 model with 30-mm tibia–rod offset. In the EF-7 model group, the maximum stiffness was 40.00 N/mm in the model with 30-mm tibia–rod offset. In the ELP model group, the maximum stiffness was 35.79 N/mm in the model with 30-mm tibia–plate offsetConclusionsExternal locking plate fixation is more flexible than conventional external fixation, which can influence secondary bone healing. External locking plate fixation requires the placement of the plate as close as possible to the skin, which allow low-profile design, because the increased distance of the plate from bone can be too flexible for bone healing.

External fixation using locking plate in distal tibial fracture: a finite element analysis

2015 ◽  
Vol 25 (6) ◽  
pp. 1099-1104 ◽  
Author(s):  
Jingwei Zhang ◽  
Nabil Ebraheim ◽  
Ming Li ◽  
Xianfeng He ◽  
Joshua Schwind ◽  
...  
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
External Fixation ◽  
Tibial Fracture ◽  
Locking Plate ◽  
Distal Tibial Fracture ◽  
Element Analysis

scholarly journals Finite Element Analysis of Different Locking-Plate Fixation Methods for the Treatment of Ulna Head Fracture

2020 ◽  
Author(s):  
Yue Zhang ◽  
Qin Shao ◽  
Chensong Yang ◽  
Changqing Ai ◽  
Di Zhou ◽  
...  
Keyword(s):  
Finite Element Analysis ◽  
Locking Plate ◽  
Plate Fixation ◽  
Dorsal Side ◽  
Locking Plate Fixation ◽  
Element Analysis ◽  
Side Plate ◽  
Ulnar Side ◽  
Ulnar Head ◽  
Fixation System

Abstract Background: Ulnar head fractures are increasingly higher with the growing proportion of the elderly in the population. Failure to achieve stable anatomic reduction of ulna head fracture may lead to the DRUJ dysfunction and nonunion of distal radius. Due to the lack of the postoperative reporting outcomes and the biomechanical studies, it has not been well established about the optimal management of the comminuted distal ulna head fracture. This study aimed to explain the advantages and disadvantages of the ulnar-side locking plate fixation, compared with the dorsal-side one, and its screws arrangement in the treatment of the ulnar head fracture by using finite element analysis. Methods: FE models of the ulnar head fracture and the models of ulnar-side locking plate and dorsal-side plate with two or three distal screws was constructed. In order to simulate forces acting on the ulnar and the osteosynthesis material during daily-life activity in subjects who underwent reconstructive surgery, we applied three loading conditions to each model, viz. axial compression 20N, 50N, and torsion moments 1Nm. Under these conditions, values of the von Mises Stress (VMS) distribution of the implant, peak VMS, and model displacement were investigated. Results: Both the stress values and model displacement of ulnar-side plate were lower than those of dorsal-side plate. When adding a screw in the middle hole of the ulnar head, the values of model displacement and the peak stress in fixation system are lower, but it may evidently concentrate the stress on the middle screw. Conclusions: In conclusion, our study indicated that plating locking plate on ulnar side had lower stress distribution on the plate and better stability than on dorsal side in ulnar head fracture fixation. Adding the additional screw on the ulnar head could reduce the displacement of the fixation system and increase the stability of the fixation system. This study requires clinical confirmation as to its practicality in the treatment of ulnar head fracture.

scholarly journals Finite element analysis of different locking-plate fixation methods for the treatment of ulna head fracture

2020 ◽  
Author(s):  
Yue Zhang ◽  
Qin Shao ◽  
Chensong Yang ◽  
Changqing Ai ◽  
Di Zhou ◽  
...  
Keyword(s):  
Finite Element Analysis ◽  
Locking Plate ◽  
Plate Fixation ◽  
Dorsal Side ◽  
Locking Plate Fixation ◽  
Element Analysis ◽  
Side Plate ◽  
Ulnar Side ◽  
Ulnar Head ◽  
Fixation System

Abstract Background: Ulnar head fractures are increasingly higher with the growing proportion of the elderly in the population. Failure to achieve stable anatomic reduction of ulna head fracture may lead to the DRUJ dysfunction and nonunion of distal radius. Due to the lack of the postoperative reporting outcomes and the biomechanical studies, it has not been well established about the optimal management of the comminuted distal ulna head fracture. This study aimed to explain the advantages and disadvantages of the ulnar-side locking plate fixation, compared with the dorsal-side one, and its screws arrangement in the treatment of the ulnar head fracture by using finite element analysis. Methods: FE models of the ulnar head fracture and the models of ulnar-side locking plate and dorsal-side plate with two or three distal screws was constructed. In order to simulate forces acting on the ulnar and the osteosynthesis material during daily-life activity in subjects who underwent reconstructive surgery, we applied three loading conditions to each model, viz. axial compression 20N, 50N, and torsion moments 1Nm. Under these conditions, values of the von Mises Stress (VMS) distribution of the implant, peak VMS, and model displacement were investigated. Results: Both the stress values and model displacement of ulnar-side plate were lower than those of dorsal-side plate. When adding a screw in the middle hole of the ulnar head, the values of model displacement and the peak stress in fixation system are lower, but it may evidently concentrate the stress on the middle screw. Conclusions: In conclusion, our study indicated that plating locking plate on ulnar side had lower stress distribution on the plate and better stability than on dorsal side in ulnar head fracture fixation. Adding the additional screw on the ulnar head could reduce the displacement of the fixation system and increase the stability of the fixation system. This study requires clinical confirmation as to its practicality in the treatment of ulnar head fracture.

scholarly journals Finite element analysis of double‐plate fixation using reversed locking compression‐distal femoral plates for Vancouver B1 periprosthetic femoral fractures

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Daisuke Takahashi ◽  
Yoshihiro Noyama ◽  
Tsuyoshi Asano ◽  
Tomohiro Shimizu ◽  
Tohru Irie ◽  
...  
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Plate Fixation ◽  
Weight Bearing ◽  
Femoral Fractures ◽  
Full Weight Bearing ◽  
Loading Test ◽  
Lateral Plate ◽  
Element Analysis ◽  
Periprosthetic Femoral Fractures

Abstract Background Internal fixation is recommended for treating Vancouver B1 periprosthetic femoral fractures. Although several fixation procedures have been developed with high fixation stability and union rates, long-term weight-bearing constructs are still lacking. Therefore, the aim of the present study was to evaluate the stability of a double-plate procedure using reversed contralateral locking compression-distal femoral plates for fixation of Vancouver B1 periprosthetic femoral fractures under full weight-bearing. Methods Single- and double-plate fixation procedures for locking compression-distal femoral plates were analysed under an axial load of 1,500 N by finite element analysis and biomechanical loading tests. A vertical loading test was performed to the prosthetic head, and the displacements and strains were calculated based on load-displacement and load-strain curves generated by the static compression tests. Results The finite element analysis revealed that double-plate fixation significantly reduced stress concentration at the lateral plate place on the fracture site. Under full weight-bearing, the maximum von Mises stress in the lateral plate was 268 MPa. On the other hand, the maximum stress in the single-plating method occurred at the defect level of the femur with a maximum stress value of 1,303 MPa. The principal strains of single- and double-plate fixation were 0.63 % and 0.058 %, respectively. Consistently, in the axial loading test, the strain values at a 1,500 N loading of the single- and double-plate fixation methods were 1,274.60 ± 11.53 and 317.33 ± 8.03 (× 10− 6), respectively. Conclusions The present study suggests that dual-plate fixation with reversed locking compression-distal femoral plates may be an excellent treatment procedure for patients with Vancouver B1 fractures, allowing for full weight-bearing in the early postoperative period.

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