A novel patella fracture fixation technique: finite element analysis

Demirtaş, Yunus; Katı, Yusuf Alper

doi:10.1007/s00402-023-04910-1

Cited by 7 publications

(5 citation statements)

References 29 publications

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“…A key part of this analysis involved conducting a sensitivity analysis, wherein we carefully adjusted and examined the impact of various parameters, including material properties and boundary conditions. Furthermore, we aligned our model's predictions with clinical observations and existing biomechanical literature [ 17 , 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

“…While some research has focused on contact pressure distribution and cartilage stresses, validating FEA models against empirical measurements remains crucial [ 15 , 16 ]. Few studies have explored parametric variations associated with symptomatic knees and treatment methods [ 17 , 18 ]. Within the scope of our investigation, our study introduces a specialized FEA modeling technique.…”

Section: Introductionmentioning

confidence: 99%

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Comparative study of locking neutralization plate construct versus tension band wiring with a cannulated screw for patella fractures: experimental and finite element analysis

Kim,

Mungalpara,

Wangikar

et al. 2024

J Orthop Surg Res

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Transverse patella fractures, accounting for approximately 1% of Orthopedic injuries, pose intricate challenges due to their vital role in knee mechanics. This study aimed to compare the biomechanical performance of a construct, integrating cannulated screws and an anterior locking neutralization plate, with the conventional tension band wiring technique for treating these fractures. Experimental testing and Finite Element Analysis were employed to evaluate the constructs and gain profound insights into their mechanical behavior. Sixteen cadaveric knees were prepared, and transverse patella fractures were induced at the midpoints using a saw. The plate construct and tension band wire fixation were randomly assigned to the specimens. A cyclic test evaluated the implants' durability and stability, simulating knee movement during extension and flexion. Tensile testing assessed the implants' maximum failure force after cyclic testing, while Finite Element Analysis provided detailed insights into stress distribution and deformation patterns. Statistical analysis was exclusively performed for the experimental data. Results showed the plate enhanced stability with significantly lower deformation (0.09 ± 0.12 mm) compared to wire fixation (0.77 ± 0.54 mm) after 500 cycles (p = 0.004). In tensile testing, the construct also demonstrated higher failure resistance (1359 ± 21.53 N) than wire fixation (780.1 ± 22.62N) (p = 0.007). Finite Element Analysis highlighted distinct stress patterns, validating the construct's superiority. This research presents a promising treatment approach for transverse patella fractures with potential clinical impact and future research prospects. This study presents a promising advancement in addressing the intricate challenges of transverse patella fractures, with implications for refining clinical practice. The construct's improved stability and resistance to failure offer potential benefits in postoperative management and patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparative study of locking neutralization plate construct versus tension band wiring with a cannulated screw for patella fractures: experimental and finite element analysis

Kim,

Mungalpara,

Wangikar

et al. 2024

J Orthop Surg Res

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“…The placement position of screws or Kirschner wires relative to the anterior surface of the patella has always been a subject of controversy [ 25 ]. In our study, when the force direction is at 0°, regardless of whether the load is 400N or 800N, placing the SCIS at 10 mm results in the smallest fracture fragment displacement and gap opening.…”

Section: Discussionmentioning

confidence: 99%

Novel screw-cable integrated system(SCIS) for minimally invasive treatment of patella transverse fractures: a finite element analysis

Liu,

et al. 2023

J Orthop Surg Res

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Background The most recommended method for treating transverse patella fractures is modified tension band wiring (MTBW). However, the optimal instrument for use with MTBW is still undetermined. Hence, we aimed to design a novel screw-cable integrated system (SCIS) and compare its biomechanical characteristics with Kirschner-wire, SCIS, and Cable-Pin systems in treating transverse patellar fracture. Methods A finite-element (FE) model of transverse patella fracture was created. The fracture model was fixed with either K-wire, SCIS, or Cable-pin. Different tension force loading (400 N and 800 N), direction(0° and 45°), and screw or K-wire depth(5 mm and 10 mm) were set. The maximum displacement of the fragment and maximum gap opening were measured by using FE analysis. Results Compared with the K-wire and Cable-pin system, SCIS increased the stability of the fractured patella by reducing fragment displacement and gap opening. Under 400 N loading in the direction 45°, SCIS with screw placing at 5-mm depth reduced the maximum fragment displacement (0.43 mm) by 49.62% and 26%, respectively, compared with the K-wire (0.22 mm) and Cable-pin (0. 22 mm) group. Meanwhile, the gap opening in SCIS (0.05 mm) was reduced by 83% and 59.8% (0.05 to 0.18) compared with the K-wire (0.30 mm) and Cable-pin (0.18 mm) group. Conclusion SCIS demonstrated improved biomechanical stability for treating transverse patellar fractures compared to MTBW with Kirschner wire and the Cable-Pin system. Finite element analysis showed SCIS substantially reduced fracture fragment displacement and gap opening under various loading conditions.

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“…Frictional contact was set between the periphery of the patella and bone tunnel wire, as well as between the patella and vertical wire, with a friction coefficient of 0.2 ( Zhu et al, 2022 ). The friction coefficient of the fractured end of the inferior pole of the patella was set to 0.45 ( Chang et al, 2018 ; Demirtaş and Kati, 2023 ).…”

Section: Methodsmentioning

confidence: 99%

Computational evaluation of wire position using separate vertical wire technique and candy box technique for the fixation of inferior pole patellar fractures: a finite element analysis

Fan,

Dang,

Tan

et al. 2024

Front. Bioeng. Biotechnol.

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The separate vertical wire (SVW) technique and the improved candy box (CB) technique have been proposed for treating inferior pole patellar fractures. However, there is still a lack of clear explanation regarding the location of the wire passing through the patella. Five models of SVW techniques were established in different positions. Finite element analysis was then conducted to determine the optimal bone tunnel position for the SVW technique. Based on these findings, six groups of finite element models were created for CB techniques. The maximum displacement and stress on both the patella and steel wire were compared among these groups under 100-N, 200-N, 300-N, 400-N, and 500-N force loads. The results indicated that, in the SVW technique, the steel wire group near the fracture end of the longitudinal bone tunnel showed minimal displacement and stress on the patella when subjected to different forces. On the other hand, in the CB technique, both the patella and wire experienced minimal stress when a transverse bone tunnel wire was placed near the upper posterior aspect of patella. In conclusion, the SVW technique may require the bone tunnel wire to be positioned near the fractured end of the lower pole of the patella. On the other hand, in CB technique, the transverse bone tunnel wire passing through the patella may be close to its upper posterior aspect. However, further validation is necessary through comprehensive finite element analysis and additional biomechanical experiments.

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A novel patella fracture fixation technique: finite element analysis

Cited by 7 publications

References 29 publications

Comparative study of locking neutralization plate construct versus tension band wiring with a cannulated screw for patella fractures: experimental and finite element analysis

Comparative study of locking neutralization plate construct versus tension band wiring with a cannulated screw for patella fractures: experimental and finite element analysis

Novel screw-cable integrated system(SCIS) for minimally invasive treatment of patella transverse fractures: a finite element analysis

Computational evaluation of wire position using separate vertical wire technique and candy box technique for the fixation of inferior pole patellar fractures: a finite element analysis

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