Newly designed anterolateral and posterolateral locking anatomic plates for lateral tibial plateau fractures: a finite element study

Chen, Pengbo; Lu, Hua; Shen, Hao; Wang, Wei; Ni, Binbin; Chen, Jishizhan

doi:10.1186/s13018-017-0531-1

Cited by 24 publications

(30 citation statements)

References 26 publications

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“…2 . For the interfacial surface between both the intramedullary nail and plate fixation systems, it was assumed that the direct contact with a frictional coefficient of 0.3 existed in the implants and bones [ 12 , 13 ]. To imitate strong contact attachment between the plate and screw, it is defined that the interaction is sharing the common nodes of elements to simulate the locking screw mechanism.…”

Section: Methodsmentioning

confidence: 99%

Finite element analysis of intramedullary nailing and double locking plate for treating extra-articular proximal tibial fractures

Chen

Huang

et al. 2018

J Orthop Surg Res

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BackgroundProximal tibia fractures are one of the most familiar fractures. Surgical approaches are usually needed for anatomical reduction. However, no single treatment method has been widely established as the standard care. Our present study aims to compare the stress and stability of intramedullary nails (IMN) fixation and double locking plate (DLP) fixation in the treatment of extra-articular proximal tibial fractures.MethodsA three-dimensional (3D) finite element model of the extra-articular proximal tibial fracture, whose 2-cm bone gap began 7 cm from the tibial plateau articular surface, was created fixed by different fixation implants. The axial compressive load on an adult knee during single-limb stance was imitated by an axial force of 2500 N with a distribution of 60% to the medial compartment, while the distal end was fixed effectively. The equivalent von Mises stress and displacement of the model was used as the output measures for analysis.ResultsThe maximal equivalent von Mises stress value of the system in the IMN model was 293.23 MPa, which was higher comparing against that in the DLP fixation model (147.04 MPa). And the mean stress of the model in the IMN model (9.25 MPa) was higher than that of the DLP fixation system in terms of equivalent von Mises stress (EVMS) (P < 0.0001). The maximal value of displacement (sum) in the IMN system was 8.82 mm, which was lower than that in the DLP fixation system (9.48 mm).ConclusionsThis study demonstrated that the stability provided by the locking plate fixation system was superior to the intramedullary nails fixation system and served as an alternative fixation for the extra-articular proximal tibial fractures of young patients.

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Section: Methodsmentioning

confidence: 99%

Finite element analysis of intramedullary nailing and double locking plate for treating extra-articular proximal tibial fractures

Chen

Huang

et al. 2018

J Orthop Surg Res

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“…So far, no single treatment method has been widely established as gold standard for all types of tibial fractures [4,5]. The most common surgical treatments include interlocking intramedullary nailing [4,6], locking compression plates [7,8] and external fixation systems [9]. Treatment failures are common and generally related to residual pain, stiffness, deformity, instability and a decrease in range of motion [1,8].…”

Section: Introductionmentioning

confidence: 99%

“…The most common surgical treatments include interlocking intramedullary nailing [4,6], locking compression plates [7,8] and external fixation systems [9]. Treatment failures are common and generally related to residual pain, stiffness, deformity, instability and a decrease in range of motion [1,8]. Moreover, residual articular incongruity, axial malalignment and instability often result in post-traumatic osteoarthritis [1,3,10].…”

Section: Introductionmentioning

confidence: 99%

“…In recent years, many studies have examined the finite element method (FEM) analysis of locking plates in order to better understand which parameters can affect the performance of this type of fixation system. They typically investigate how number, length, type, or shape of the screws and the shape of the plates affect the implant stability [4,8,[17][18][19][20][21]. Some authors [22] have demonstrated the influence of the screw configuration on the stability of tibial tubercle osteotomy (without plates), but as far as we know, the influence of the screw configuration on the stability of tibial locking plates has not yet been adequately analysed.…”

Section: Introductionmentioning

confidence: 99%

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Influence of the Screw Positioning on the Stability of Locking Plate for Proximal Tibial Fractures: A Numerical Approach

et al. 2020

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Tibial fractures are common injuries in people. The proper treatment of these fractures is important in order to recover complete mobility. The aim of this work was to investigate if screw positioning in plates for proximal tibial fractures can affect the stability of the system, and if it can consequently influence the patient healing time. In fact, a more stable construct could allow the reduction of the non-weight-bearing period and consequently speed up the healing process. For that purpose, virtual models of fractured bone/plate assemblies were created, and numerical simulations were performed to evaluate the reaction forces and the maximum value of the contact pressure at the screw/bone interface. A Schatzker type I tibial fracture was considered, and four different screw configurations were investigated. The obtained results demonstrated that, for this specific case study, screw orientation affected the pressure distribution at the screw/bone interface. The proposed approach could be used effectively to investigate different fracture types in order to give orthopaedists useful guidelines for the treatment of proximal tibial fractures.

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“…Tibial plateau fractures are common in clinical practice, accounting for 1% of all fractures 1,2 and somewhat difficult to manage. Fractures can be caused by high-energy or lowenergy trauma and can occur at any age.…”

mentioning

confidence: 99%

A Modified Direct Posterior Midline Approach for the Treatment of Posterior Column Tibial Plateau Fractures

Yin

Yang

et al. 2019

J Knee Surg

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The purpose of this study was to introduce a modified surgical approach for the treatment of posterior column tibial plateau fractures. Fifteen patients with posterior column fractures with or without other column fractures were included and treated with this approach between July 2015 and June 2016. The patients were followed up for 18 to 24 months (20.9 ± 1.8 months). Outcomes included neural or vascular injuries, wound complications, nonunion, plate loosening or breakage, and Hospital for Special Surgery (HSS) scores. Bone union was observed in all cases, and the average time for bone union was 13.5 ± 1.4 weeks (11–16 weeks). No neurovascular injuries, malunion, nonunions, or plate loosening or breakages were observed. The average HSS score was 94.7 ± 4.1 (range: 84–100). The modified direct posterior midline approach can provide excellent exposure and facilitate reduction and internal fixation of posterior column fractures of the tibial plateau, including split and depressed fractures. We expect that this approach can be used as a new effective method for managing complex posterior tibial fractures.

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Newly designed anterolateral and posterolateral locking anatomic plates for lateral tibial plateau fractures: a finite element study

Cited by 24 publications

References 26 publications

Finite element analysis of intramedullary nailing and double locking plate for treating extra-articular proximal tibial fractures

Finite element analysis of intramedullary nailing and double locking plate for treating extra-articular proximal tibial fractures

Influence of the Screw Positioning on the Stability of Locking Plate for Proximal Tibial Fractures: A Numerical Approach

A Modified Direct Posterior Midline Approach for the Treatment of Posterior Column Tibial Plateau Fractures

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