A comparative analysis of titanium anatomic plate and titanium reconstructive plate for treatment of extra-articular fractures of the scapula (Miller types IIb, IIc, and IV)

Zhang, Jian; Li, Yihan; Yang, Bi; Chu, Xin; Cao, Yang

doi:10.1016/j.jse.2021.12.008

Cited by 3 publications

(8 citation statements)

References 21 publications

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“…Zhang et al previous study showed that the anatomic plate could avoid excessive pre-bending and reduce operative time and blood loss during the intraoperative [ 9 ]. However, this was a retrospective study limited by the number of clinical cases.…”

Section: Discussionmentioning

confidence: 99%

“…Considering these problems and the reasons for the risk of complications, a novel titanium anatomic plate was designed for scapular fractures. Zhang et al retrospectively analyzed the clinical data of 41 scapular fracture patients with at least 12 months of follow-up [ 9 ]. Compared with the reconstructive plates, the anatomic plates had obvious advantages that could shorten the operation time, reduce intraoperative blood loss, and promote the early recovery of patients.…”

Section: Introductionmentioning

confidence: 99%

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Finite element analysis of titanium anatomic plate and titanium reconstructive plate for treatment of extra-articular fractures of the scapula

Shang¹,

Bi²,

Cao³

et al. 2023

J Orthop Surg Res

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Background Due to the lack of postoperative reporting outcomes and bio-mechanical studies, an optimal management of scapular fractures has not been well-established in clinical treatment, even though there are many options available. This study aimed to compare the stability of the new titanium anatomic and traditional titanium reconstructive plates for extra-articular scapular fractures through finite element analysis. Methods Two models of scapular assembly were constructed, including one anatomic plate (AP model) and one reconstructive plate (RP model). After meshing, material parameter, and boundary condition settings, we applied four loading conditions to simulate forces acting on the scapula and osteosynthesis material. To evaluate the bio-mechanical properties, the equivalent von Mises stress, equivalent elastic strain, and total deformation were investigated. Result The stress and strain distribution of model AP has better performance than model RP, with more uniform and lower values. The maximum stress value of the scapula in model AP is smaller than that of the scapula in model RP (102.83 MPa vs. 166.71 MPa). The maximum stress of the anatomic plate is half that of the reconstructive plate (218.34 MPa vs. 416.01 MPa). The maximum strain of the scapula in model AP is smaller than that of the scapula in model RP (0.0071 vs. 0.0106). The maximum strain of the anatomic plate is half that of the reconstructive plate (0.0019 vs. 0.0037). The maximum displacement of each model is all at the acromion, with a similar value (2.2947 mm vs. 1.8308 mm). Conclusions With sufficient bio-mechanical stability, the anatomic plate to support scapular fracture fragments was superior to that of the reconstructive plate.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Finite element analysis of titanium anatomic plate and titanium reconstructive plate for treatment of extra-articular fractures of the scapula

Shang¹,

Bi²,

Cao³

et al. 2023

J Orthop Surg Res

Self Cite

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“…Moreover, SNFs are in a deep position and are often overlooked [ 17 , 18 ]. In the past, most scholars have recommended conservative treatment for such fractures, but with medical advances and improved understanding of the anatomy and biomechanics of the scapular neck, orthopedic surgeons who treat SNFs agree that surgical rather than conservative treatment of unstable scapular fractures improves patient outcomes [ 3 , 11 , 12 , 19 , 20 ]. Open reduction and internal fixation in the treatment of SNFs are beneficial to early postoperative functional exercise, reduce pain, and prevent complications such as malunion, muscle imbalance, rotator cuff dysfunction, scapulothoracic dyskinesis and impingement [ 9 , 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…They believed that RP for SNFs can ensure solid fixation and enable early functional exercise of the shoulder. However, J. Zhang et al [ 12 ] believed that the anatomical structure of the scapula is special and that the reconstructed plate needs to be shaped repeatedly during surgery, which prolongs the surgical time and affects material strength and screw placement, resulting in an increased risk of postoperative infection, failure of internal fixation, and displacement of the fracture end. In their retrospective controlled clinical study, the authors aimed to compare the therapeutic efficacy of double-row titanium anatomical plates and reconstruction plates for extra-articular fractures of the scapula, finding that there was less intraoperative blood loss and shorter surgical duration in the anatomical plate group than in the reconstruction plate group, and that these differences were statistically significant ( P < 0.01).…”

Section: Discussionmentioning

confidence: 99%

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Finite element analysis of a novel anatomical locking plate for scapular neck fracture

et al. 2023

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Objectives Reconstruction plates (RPs) are commonly used in scapular neck fractures (SNFs): however, RPs have many defects. In this study, we evaluated a newly designed scapular neck anatomical locking compression plate (SNALCP). Methods An SNF finite element model (Miller-type IIB) was constructed. Plates were subsequently implanted into the scapula and fixed with screws that were grouped according to the plate used: SNALCP (A) and RP (B). Finally, loads were applied to record and analyze performance. Results Under lateral, anteroposterior, and vertical compression loads, the maximum von Mises stresses on the scapula and implants of group A were smaller than those of group B. There were some differences in stress distribution between the two groups. Conclusions SNALCP can effectively reduce the stress of the scapula and implant, making stress distribution more uniform and continuous, and has mechanical conduction advantages. Compared to RP, it provides improved stability and more reliable fixation.

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Finite element analysis of the treatment of a minimally invasive approach combined with a novel anatomical locking plate for scapular body fractures

Guo,

Wang

et al. 2024

J Orthop Surg Res

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Background The minimally invasive approach for the treatment of displaced scapular neck or body fractures has the advantages of less trauma and minimal muscle dissection. In clinical practice, the minimally invasive approach combined with an anatomical locking plate has been used to treat scapular body fractures. In addition, we have made minor modifications to the minimally invasive approach. However, the biomechanical study about the approach combined with an anatomical locking plate in treating scapular body fractures was limited. Methods Finite element analysis (FEA) was used to conduct the biomechanical comparison between the anatomical locking plate (AP model) and reconstructive plate (RP model) in the treatment of scapular body fractures through the modified minimally invasive approach. A healthy male volunteer with no history of scapula or systemic diseases was recruited. High-resolution computed tomography images of his right scapula were obtained. Two scapula models were constructed and analyzed by the software of Mimics 21.0, Geomagic Wrap 2021, SolidWorks 2021, and ANSYS Workbench 2022, respectively. Results Through static structural analysis, in terms of equivalent von Mises stress, equivalent elastic strain, and total deformation, the AP model exhibited superior safety characteristics, enhanced flexibility, and anticipated stability compared with the RP model. This was evidenced by lower maximum stress, lower maximum strain and displacement. Conclusion The minimally invasive approach combined with an anatomical locking plate for scapular body fractures had better biomechanical stability. The study provided a biomechanical basis to guide the clinical treatment of scapular body fractures.

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A comparative analysis of titanium anatomic plate and titanium reconstructive plate for treatment of extra-articular fractures of the scapula (Miller types IIb, IIc, and IV)

Cited by 3 publications

References 21 publications

Finite element analysis of titanium anatomic plate and titanium reconstructive plate for treatment of extra-articular fractures of the scapula

Finite element analysis of titanium anatomic plate and titanium reconstructive plate for treatment of extra-articular fractures of the scapula

Finite element analysis of a novel anatomical locking plate for scapular neck fracture

Finite element analysis of the treatment of a minimally invasive approach combined with a novel anatomical locking plate for scapular body fractures

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