Finite element analysis of spiral plate and Herbert screw fixation for treatment of midshaft clavicle fractures

Zhang, Yingze; Cheng, Xiaodong; Yin, Bing; Wang, Jianzhao; Li, Sheng; Liu, Guobin; Hu, Zusheng; Wu, Weiwei

doi:10.1097/md.0000000000016898

Cited by 8 publications

(10 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Discussionmentioning

confidence: 99%

“…Therefore, some finite element studies recommend different types of plates, such as anterior plates, spiral plates, and superior plates with no screw holes above the fracture area. [17,18,20,21] A comminuted MCF model was secured with a 7-hole titanium superior LCP, and FEA was performed between the with LSC model and without LSC model on top of the fracture site. The 7 stress measurement points represent the stress geometrically generated at the same point on the edge of the LCP hole.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Numerical simulation and biomechanical analysis of locking screw caps on clavicle locking plates

Kim

2022

Medicine

View full text Add to dashboard Cite

Background: The risk of displaced and comminuted midshaft clavicle fractures is increased in high-energy traumas such as sport injuries and traffic accidents. Open reduction and plate fixation have been widely used for midshaft clavicle fractures. Among various plates for clavicle shaft fractures, superior locking compression plates (LCPs) have been mostly used. In plate fixation, nonunion caused by implant failure is the most difficult complication. The most common reasons for metal plate failure are excessive stress and stress concentration caused by cantilever bending. These causes were easily addressed using a locking screw cap (LSC). Methods: The clavicle 3-dimensional image was made from a computed tomography scan, and the clavicle midshaft fracture model was generated with a 10-mm interval. The fracture model was fixed with a superior LCP, and finite element analysis was conducted between the presence (with LSC model) and absence (without LSC model) of an LSC on the site of the fracture. The stresses of screw holes in models with and without LSCs were measured under 3 forces: 100 N cantilever bending force, 100 N axial compression force, and 1 N·m axial torsion force. After the finite element analysis, a validation test was conducted on the cantilever bending force known as the greatest force applied to superior locking plates. Results: The mean greatest stress under the cantilever bending force was significantly greater than other loading forces. The highest stress site was the screw hole edge on the fracture site in both models under the cantilever bending and axial compression forces. Under the axial torsional force, the maximum stress point was the lateral first screw hole edge. The ultimate plate stress of the with LSC model is completely lower than that of the without LSC model. According to the validation test, the stiffness, ultimate load, and yield load of the with LSC model were higher than those of the without LSC model. Conclusions: Therefore, inserting an LSC into an empty screw hole in the fracture area reduces the maximum stress on an LCP and improves biomechanical stability.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Numerical simulation and biomechanical analysis of locking screw caps on clavicle locking plates

Kim

2022

Medicine

View full text Add to dashboard Cite

show abstract

“…In the viewpoint of biomechanics, the clavicle plate mainly provided stability in bending directions [26] . In this study, the comparative analysis of structural stiffness showed that the structural stiffness of the magnesium alloy plate was close to but slightly larger than that of the intact clavicle under the bending condition, followed by titanium alloy and stainless steel plates.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, the properties of all types of materials were assumed to be homogeneous, isotropic, and linearly elastic. This assumption was made regarding previous studies [7,9,18,26,30] , which discussed the FE analysis of plate fixation to treat midshaft clavicle fractures. Although this assumption was slightly different from the actual conditions, we believe the conclusion of this study should be the same.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical Analysis of Personalised 3D-Printed Clavicle Plates of Different Materials to Treat Midshaft Clavicle Fractures

Cheng

程荣山

Jiang

et al. 2021

J. Shanghai Jiaotong Univ. (Sci.)

View full text Add to dashboard Cite

This study was aimed at comparing the biomechanical performance of personalised 3D-printed clavicle plates of different materials to treat midshaft clavicle fractures with the finite element (FE) method. The FE model of a fractured clavicle with a personalised 3D-printed clavicle plate and screws was constructed. Three types of materials were simulated, including stainless steel, titanium alloy, and magnesium alloy. Two loading conditions (axial compression and inferior bending) were applied at the distal end of the clavicle to simulate arm abduction. Plate stiffness, peak stress, and bone strain at the clavicle fracture site were measured and compared. The stiffness of the stainless steel clavicle plate was significantly greater than that of the titanium alloy clavicle plate. The stiffness of the magnesium alloy clavicle plate was similar to that of the intact clavicle; peak stress of the magnesium alloy clavicle plate was the lowest; thus, it had less stress-shielding effects on bone formation. The magnesium alloy clavicle plate was more likely to form bone by distributing proper strain at the clavicle fracture site. According to the influence of different materials on the tensile strength, magnesium alloy clavicle plates might be preferred owing to their bionic stiffness in the treatment of patients with a low risk of falling. For patients who engage in contact sports, a titanium alloy clavicle plate might be more suitable.

show abstract

“… 20 In all loading cases, an arbitrary static total force/torsion of 100 N/1 Nm was equally distributed on the relevant surface nodes situated at the 15‐mm most distal part of the clavicle. The sternal end of the clavicle was fixed in translation and rotation to avoid rigid‐body modes 22 …”

Section: Methodsmentioning

confidence: 99%

Canceling Notch Improves the Mechanical Safety of Clavicle Locking Plate: A 3D Finite Element Study

Han

Luo

Deng

et al. 2022

Orthopaedic Surgery

View full text Add to dashboard Cite

ObjectiveImplant failure is a disastrous complication of the operative treatment of midshaft clavicle fractures, and improving the osteosynthesis plate is a strategy for preventing this. We aimed to investigate whether canceling the notch and adding screw‐hole inserts enhanced the mechanical properties of the plate.MethodsA clavicle model was generated based on the CT images of six adult volunteers (age range, 20–40 years; three males and three females; height range 160–175) using dedicated software, and a midshaft fracture model was created. The domestically made seven‐hole locking plate commonly used for midshaft clavicle fractures was simulated (Model I); modifications were made to the plate (Model II). Using 3D finite element analysis, we simulated the fracture construct under three different load conditions—downward cantilever bending, axial compression, and axial torsion—and compared the stress distribution.ResultsWe found that under axial compression, Model II experienced its maximum stress on the plate at 551.9MPa, which was less than that in Model I (790.4 MPa). Moreover, a greater stress concentration at the fracture site was observed under axial torsion, despite the maximum stress of both the models being similar.ConclusionCanceling the notch and filling the screw holes near the fracture can ameliorate stress concentration on the internal fixation construct and enhance its reliability under axial compression. This improvement has substantial effects on the mechanical properties of implants and potentially prevents implant failure. Modern osteosynthesis anatomical implants need to be improved.

show abstract

Finite element analysis of spiral plate and Herbert screw fixation for treatment of midshaft clavicle fractures

Cited by 8 publications

References 37 publications

Numerical simulation and biomechanical analysis of locking screw caps on clavicle locking plates

Numerical simulation and biomechanical analysis of locking screw caps on clavicle locking plates

Biomechanical Analysis of Personalised 3D-Printed Clavicle Plates of Different Materials to Treat Midshaft Clavicle Fractures

Canceling Notch Improves the Mechanical Safety of Clavicle Locking Plate: A 3D Finite Element Study

Contact Info

Product

Resources

About