Biomechanical effect of the configuration of screw hole style on locking plate fixation in proximal humerus fracture with a simulated gap: A finite element analysis

Zhang, Yakui; Wei, Hung-Wen; Lin, K.M.; Chen, Wen-Chuan; Tsai, Cheng-Lun; Lin, Kun-Jhih

doi:10.1016/j.injury.2016.02.028

Cited by 38 publications

(46 citation statements)

References 20 publications

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“…This may also affect the values of σ mean and σ max . Moreover, we modelled perfect locking of the screws by merging them to the plate and modelled the ideal bone-screw purchase by tying the screws to the bone, as described by Zhang et al 47. This was because the pull-out of screws was not observed in our in vitro tests.…”

Section: Discussionmentioning

confidence: 99%

“…Such comparative studies are still performed today as demonstrated by Zhou et al ., who compared the biomechanical stability and stress of two locking compression plates for middle femoral fracture 49. Many FE studies on proximal humerus plates belong to this category as they investigated the effect of bone cement augmentation, medial support and screw configurations 15,23,44,47…”

Section: Introductionmentioning

confidence: 99%

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Parametric Design Optimisation of Proximal Humerus Plates Based on Finite Element Method

et al. 2018

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Optimal treatment of proximal humerus fractures remains controversial. Locking plates offer theoretical advantages but are associated with complications in the clinic. This study aimed to perform parametric design optimisation of proximal humerus plates to enhance their mechanical performance. A finite element (FE) model was developed that simulated a two-part proximal humerus fracture that had been treated with a Spatial Subchondral Support (S3) plate and subjected to varus bending. The FE model was validated against in vitro biomechanical test results. The predicted load required to apply 5 mm cantilever varus bending was only 0.728% lower. The FE model was then used to conduct a parametric optimisation study to determine the orientations of inferomedial plate screws that would yield minimum fracture gap change (i.e. optimal stability). The feasible design space was automatically identified by imposing clinically relevant constraints, and the creation process of each FE model for the design optimisation was automated. Consequently, 538 FE models were generated, from which the obtained optimal model had 4.686% lower fracture gap change (0.156 mm) than that of the manufacturer’s standard plate. Whereas its screws were oriented towards the inferomedial region and within the range of neck-shaft angle of a healthy subject. The methodology presented in this study promises future applications in patient-specific design optimisation of implants for other regions of the human body.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Parametric Design Optimisation of Proximal Humerus Plates Based on Finite Element Method

et al. 2018

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“…Las cargas fisiológicas que se ejercen en la extremidad superior son difíciles de definir debido a la compleja matriz de los músculos responsables del movimiento [21]. Sin embargo, se ha publicado una considerable cantidad de evidencia sobre diferentes procedimientos utilizados para estimar las cargas fisiológicas presentadas durante distintas actividades diarias y particularmente en la posición de -caer sobre un brazo estirado‖, siendo esta última, ampliamente aceptada al aplicar una carga puntual de compresión vertical en la cabeza humeral [47,48]. En el presente, muy pocos estudios han examinado el desempeño biomecánico de los sistemas de fijación bajo cargas que representen la posición de -sostener un peso muerto‖.…”

Section: Condiciones De Carga Y De Fronteraunclassified

“…Esta investigación busca analizar la condición antes descrita, al aplicar una carga puntal de tensión en la cabeza humeral. Se ha decidido elegir una magnitud de carga de 50 -150N en base a los estudios realizados por ZHANG et al [48]. Adicionalmente, se propone estudiar el sistema de fijación considerando tareas que resultan en flexión (Figura 4(b)) y torsión (Figura 4(c)) del brazo.…”

Section: Condiciones De Carga Y De Fronteraunclassified

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Análisis de los elementos principales en el diseño de placas de bloqueo en una fractura de 2-partes del cuello quirúrgico del húmero utilizando MEF y análisis estadístico

Mendoza-Muñoz¹,

González-Ángeles²,

Jacobo-Galicia³

et al. 2018

Matéria (Rio J.)

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RESUMEN Un gran número de fracturas de húmero proximal están siendo tratadas con osteosíntesis. Sin embargo, la pérdida de reducción sigue siendo un problema grave, lo que lleva al recorte de tornillo en la articulación humeral y la reoperación. De acuerdo con la teoría del strain interfragmentario, se debe considerar el equilibrio entre una fijación flexible, que estimula la formación de callos, y una fijación inestable, que conduce al fallo del implante. Los principales elementos implicados en este caso son las condiciones fisiológicas de carga, la configuración de los tornillos de soporte, el material del implante y la calidad ósea. El objetivo de esta investigación es detectar la influencia de los elementos anteriores para formular una escena positiva que minimice el riesgo de fracaso. Se utilizó un diseño de experimentos de tipo factorial en combinación con el uso del método de elementos finitos para dar lugar a la recogida de datos. Las condiciones de carga asemejan a: “sostener un peso muerto” (tensión), “levantar frontalmente un peso muerto” (flexión) y torsión. Los resultados sugirieron que el material del implante es el elemento con mayor influencia y contribuye a estabilizar la fijación de la fractura, siguiendo la configuración de soporte. La práctica de incluir un soporte medial con tornillos calcar en diferentes calidades de tejido óseo ofrece una rigidez favorable que aquellos que no los utilizan. Esta afirmación es apoyada por resultados de informes publicados recientemente. Además, el soporte medial reduce el strain en la interfaz hueso-implante. Aunque estos resultados mostraron una evaluación demasiado moderada por el uso de un modelo isotrópico, son eficaces para conocer los elementos biomecánicos y su influencia para describir una tendencia de comportamiento y crear una base para futuros estudios. Además, el tiempo de cálculo disminuyó considerablemente.

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Designing a Novel Porous Fixation Plate with a Gyroid Lattice Structure for Humerus Fractures Using a Probabilistic Approach

Kaymaz,

Yavuz,

Murat

et al. 2023

Adv Eng Mater

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Conventional fixation plates permanently attached to the body can lead to complications, such as stress shielding and aseptic loosening, due to their contact with the bone, resulting in bone loss. The contact between these solid fixation plates and the bone surface inhibits blood flow, potentially leading to necrosis at the interface. To overcome this challenge, a porous implant featuring a gyroid lattice structure for humerus bone fixation is proposed. However, designing such an implant typically involves deterministic approaches, which do not account for uncertainties in design parameters, loadings on the plate, and additive manufacturing process parameters. Consequently, the actual conditions experienced by the plate may not be accurately modeled. Herein, both deterministic and probabilistic analyses of a porous implant with a gyroid lattice structure positioned on the humeral bone is conducted. The findings are compared to the failure probabilities of both the conventional fixation plate and the optimal plate derived from a previous study. The study reveals that uncertainties in design parameters significantly influence the plate's failure probability compared to deterministic analysis, emphasizing the importance of probability‐based analyses for a reliable plate design.

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Biomechanical effect of the configuration of screw hole style on locking plate fixation in proximal humerus fracture with a simulated gap: A finite element analysis

Cited by 38 publications

References 20 publications

Parametric Design Optimisation of Proximal Humerus Plates Based on Finite Element Method

Parametric Design Optimisation of Proximal Humerus Plates Based on Finite Element Method

Análisis de los elementos principales en el diseño de placas de bloqueo en una fractura de 2-partes del cuello quirúrgico del húmero utilizando MEF y análisis estadístico

Designing a Novel Porous Fixation Plate with a Gyroid Lattice Structure for Humerus Fractures Using a Probabilistic Approach

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