Finite element analysis of different fixation methods of screws on absorbable plate for rib fractures

Xue, Hang; Zhang, Zhenhe; Liu, Mengfei; Lin, Ze; Endo, Yori; Liu, Guodong; Mi, Bobin; Zhou, Wu; Liu, Guohui

doi:10.3389/fbioe.2022.960310

Cited by 3 publications

(3 citation statements)

References 21 publications

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“…Yet, this procedure is known to increase trauma (19). In the FEM study, exceeding the capacity of the material properties would be deemed as failure of fracture fixation (20)(21)(22). In clinical reality, it is widely assumed that-if internal fixation of a tibial plateau fracture is deemed suboptimal-the patient must be instructed to perform severely limited weight bearing and/or limited range of knee motion.…”

Section: Discussionmentioning

confidence: 99%

Different internal fixation methods for Hoffa-like fractures of the tibial plateau: a finite element analysis

et al. 2023

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Due to the low incidence of posteromedial tibial plateau fractures and limited clinical data available, the optimal treatment for this type of fracture remains to be established. This type of fracture, also known as Hoffa-like fracture of the tibial plateau, shares a similar mechanism of injury with the Hoffa fracture of the femoral condyle. In the field of orthopedics, finite element analysis is considered a valuable method to guide clinical decision-making. In this study, four methods used for internal fixation of Hoffa-like fractures of the tibial plateau were compared using computer simulation and applying a finite element method (FEM). The methods compared were lateral L-plate fixation alone (Model A); lateral L-plate combined with posterior anti-slip plate (reconstruction plate/T-plate) fixation (Model B); lateral L-plate combined with posterior hollow nail fixation of the fracture block (Model C); and lateral L-plate combined with anterior hollow nail fixation of the fracture (Model D). The maximum displacement of the model and the maximum stress of the internal fixation material were analyzed by applying an axial load of 2,500 N. The results showed that, in the normal bone model, the maximum displacement of the fracture in Model A was 0.60032 mm, with improved stability through the addition of posterior lateral plate fixation in Model B and reduction of the displacement to 0.38882 mm. The maximum displacement in Model C and Model D was comparable, amounting to 0.42345 mm and 0.42273 mm, respectively. Maximum stress was 1235.6 MPa for Model A, 84.724 MPa for Model B, 99.805 MPa for Model C, and 103.19 MPa for Model D. In the internal fixation analysis of the osteoporotic fracture model, we observed patterns similar to the results of the normal bone model. The results indicated that Model B yielded the overall best results in the treatment of Hoffa-like fractures of the tibial plateau. The orthopedic surgeon may wish to implement these insights into the perioperative algorithm, thereby refining and optimizing clinical patient care. In addition, our findings pave the way for future research efforts.

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Section: Discussionmentioning

confidence: 99%

Different internal fixation methods for Hoffa-like fractures of the tibial plateau: a finite element analysis

et al. 2023

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“…All materials were modeled as homogeneous and linearly isotropic. The material properties used in this study are as previously described ( Bartolin et al, 2021 ; Du et al, 2022 ; Xue et al, 2022 ). The parameters of the various materials are listed in Table 1 .…”

Section: Methodsmentioning

confidence: 99%

“…To simulate the actual situation of the contact relationship, all contact types were set within the Coulomb friction law: bone–bone (friction coefficient: μ = 0.45), bone–implant (μ = 0.3), and implant–implant (μ = 0.2) ( Chen et al, 2019 ; Zeng et al, 2020 ; Xue et al, 2022 ). Cortical and cancellous bones were used as binding contacts.…”

Section: Methodsmentioning

confidence: 99%

Tension band high-strength suture combined with absorbable cannulated screws for treating transverse patellar fractures: finite element analysis and clinical study

Xiang,

Xiao,

et al. 2024

Front. Bioeng. Biotechnol.

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Objective: Few reports exist on the treatment of transverse patellar fractures (TPFs) using absorbable cannulated screws and high-strength sutures, and most screws and sutures lack good biomechanics and clinical trials. Therefore, this study aimed to demonstrate the biomechanical stability and clinical efficacy of tension-band high-strength sutures combined with absorbable cannulated screws (TBSAS) in treating TPFs (AO/OTA 34 C1).Methods: Finite element models of five internal fixation schemes were established: tension-band wire with K-wire (TBW), TBW with cerclage wire (TBWC), TBW with headless pressure screws (TBWHS), TBW with full-thread screws (TBWFS), and TBSAS. We comprehensively compared the biomechanical characteristics of the TBSAS treatment scheme during knee flexion and extension. Forty-one patients with TPFs in our hospital between January 2020 and August 2022 were retrospectively enrolled and divided into the TBSAS (n = 22) and TBWC (n = 19) groups. Clinical and follow-up outcomes, including operative time, visual analog scale (VAS) pain score, postoperative complications, Bostman score, and final knee range of motion, were compared between both groups.Results: Finite element analysis (FEA) showed that TBWHS and TBWFS achieved the minimum mean fracture interface relative displacement during knee flexion (45°, 0–500 N bending load) and full extension (0°, 0–500 N axial load). There was no significant difference between TBSAS (0.136 mm) and TBWC (0.146 mm) during knee flexion (500 N); however, TBSAS displacement was smaller (0.075 mm) during full extension (500 N). Furthermore, the stress results for the internal fixation and the patella were generally lower when using TBSAS. Retrospective clinical studies showed that the TBSAS group had a shorter operative time, lower VAS pain score at 1 and 2 months postoperatively, better Bostman knee function score at 3 and 9 months postoperatively, and better final knee joint motion than the TBWC group (all p < 0.05). There were five cases (26.3%) of internal fixation stimulation complications in the TBWC group.Conclusion: TBSAS demonstrated excellent safety and effectiveness in treating TPFs. It is sufficient to meet the needs of TPF fixation and early functional exercise and effectively reduces metal internal fixation-induced complications and secondary surgery-induced trauma.

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A biomechanical study of a polymer material bundled rib fracture fixator

Zhang,

Wang,

Gong

et al. 2024

THC

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BACKGROUND: Rib fractures are one of the most common blunt injuries, accounting for approximately 10% of all trauma patients and 60% of thoracic injuries. Multiple rib fractures, especially flail chest, can cause local chest wall softening due to the loss of rib support, leading to paradoxical breathing, severe pain, and a high likelihood of accompanying lung contusions. OBJECTIVE: This study investigates the mechanical properties of a new polymer material rib internal fixator to provide theoretical data for its clinical use. METHODS: We conducted in vitro mechanical tests on 20 fresh caudal fin sheep ribs, using different fracture models across four randomly assigned groups (five ribs per group). The fixators were assessed using non-destructive three-point bending, torsion, and unilateral compression tests, with results averaged. Additionally, finite element analysis compared stress and strain in the polymer fixators and titanium alloy rib plates during bending and torsion tests. RESULTS: In vitro tests showed that the polymer fixators handled loads effectively up to a maximum without increase beyond a certain displacement. Bending and torsion tests via finite element analysis showed the polymer material sustained lower maximum equivalent stresses (84.455 MPa and 14.426 MPa) compared to titanium alloy plates (219.88 MPa and 46.47 MPa). CONCLUSION: The polymer rib fixator demonstrated sufficient strength for rib fracture fixation and was superior in stress management compared to titanium alloy plates in both bending and torsion tests, supporting its potential clinical application.

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Finite element analysis of different fixation methods of screws on absorbable plate for rib fractures

Cited by 3 publications

References 21 publications

Different internal fixation methods for Hoffa-like fractures of the tibial plateau: a finite element analysis

Different internal fixation methods for Hoffa-like fractures of the tibial plateau: a finite element analysis

Tension band high-strength suture combined with absorbable cannulated screws for treating transverse patellar fractures: finite element analysis and clinical study

A biomechanical study of a polymer material bundled rib fracture fixator

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