The comparison of stress and strain between custom-designed bone plates (CDBP) and locking compression plate (LCP) for distal femur fracture

Shams, Seyedeh Fatemeh; Mehdizadeh, Alireza; Movahedi, Mohammad Mehdi; Paydar, Shahram; Haghpanah, Seyyed Arash

doi:10.1007/s00590-021-03160-4

Cited by 5 publications

(3 citation statements)

References 32 publications

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“…Similarly, Rosell-Pradas et al 50 used FEMs for 7-, 9-, and 11-hole commercial DFLPs to show slightly higher axial stiffness and peak plate stress, slightly lower peak bone stress, but almost no change in AIM. Moreover, Shams et al 51 created FEMs of tailor-made 4-hole DFLPs with optimized thicknesses (4.5–6 mm) to reduce peak plate stresses by 10%–40% versus an unknown 10-hole commercial plate.…”

Section: Resultsmentioning

confidence: 99%

“…Almost all DFLP studies used transverse gaps of 2–60 mm width to mimic real clinical comminuted fractures in patients, while two studies created transverse non-gap osteotomies of 0–0.5 mm width to replicate a simple fracture, 50,63 but two studies did not report fracture details. 51,52 The explanation may be that transverse-type injuries are easier to simulate, while gap-type injuries mimic the worst case scenario from a mechanical viewpoint. Even so, future DFLP design optimization studies could investigate obliquely-angled fractures.…”

Section: Discussionmentioning

confidence: 99%

“…Details for study protocols, specimen configurations, and outcome metrics are summarized for articles examining the effects of plate geometry or position (Table 1), plate material (Table 2), screw distribution (Table 3), and screw size, number, angle, or material (Table 4). 16,[18][19][20]22,23,[49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65] Each table's last column also indicates if studies satisfied BOCs for their DFLP or, at the very least, reported outcomes that could be evaluated using those criteria. When a numerical value for ''p'' is given below, it refers to the statistical criterion reported by most experimental studies to interpret differences in results between two or more test groups (i.e.…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

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Biomechanical design optimization of distal femur locked plates: A review

Zdero

Gide

Brzozowski

et al. 2023

Proc Inst Mech Eng H

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Clinical findings, manufacturer instructions, and surgeon’s preferences often dictate the implantation of distal femur locked plates (DFLPs), but healing problems and implant failures still persist. Also, most biomechanical researchers compare a particular DFLP configuration to implants like plates and nails. However, this begs the question: Is this specific DFLP configuration biomechanically optimal to encourage early callus formation, reduce bone and implant failure, and minimize bone “stress shielding”? Consequently, it is crucial to optimize, or characterize, the biomechanical performance (stiffness, strength, fracture micro-motion, bone stress, plate stress) of DFLPs influenced by plate variables (geometry, position, material) and screw variables (distribution, size, number, angle, material). Thus, this article reviews 20 years of biomechanical design optimization studies on DFLPs. As such, Google Scholar and PubMed websites were searched for articles in English published since 2000 using the terms “distal femur plates” or “supracondylar femur plates” plus “biomechanics/biomechanical” and “locked/locking,” followed by searching article reference lists. Key numerical outcomes and common trends were identified, such as: (a) plate cross-sectional area moment of inertia can be enlarged to lower plate stress at the fracture; (b) plate material has a larger influence on plate stress than plate thickness, buttress screws, and inserts for empty plate holes; (c) screw distribution has a major influence on fracture micro-motion, etc. Recommendations for future work and clinical implications are then provided, such as: (a) simultaneously optimizing fracture micro-motion for early healing, reducing bone and implant stresses to prevent re-injury, lowering “stress shielding” to avoid bone resorption, and ensuring adequate fatigue life; (b) examining alternate non-metallic materials for plates and screws; (c) assessing the influence of condylar screw number, distribution, and angulation, etc. This information can benefit biomedical engineers in designing or evaluating DFLPs, as well as orthopedic surgeons in choosing the best DFLPs for their patients.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Characteristics Of the Studiesmentioning

confidence: 99%

See 1 more Smart Citation

Biomechanical design optimization of distal femur locked plates: A review

Zdero

Gide

Brzozowski

et al. 2023

Proc Inst Mech Eng H

View full text Add to dashboard Cite

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Design considerations for patient-specific bone fixation plates: a literature review

Brouwer de Koning,

de Winter,

Moosabeiki

et al. 2023

Med Biol Eng Comput

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Finite element analysis and optimization studies on tibia implant of SS 316L steel and Ti6Al4V alloy

Sathone,

Potdar

2024

Biomed. Phys. Eng. Express

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Tibial fractures account for approximately 15% of all fractures, typically resulting from high-energy trauma. A critical surgical approach to treat these fractures involves the fixation of the tibia using a plate with minimally invasive osteosynthesis. The selection and fixation of the implant plate are vital for stabilizing the fracture. This selection is highly dependent on the plate’s stability, which is influenced by factors like the stresses generated in the plate due to the load on the bone, as well as the plate’s length, thickness, and number of screw holes. Minimizing these stresses is essential to reduce the risk of implant failure, ensuring optimal stress distribution and promoting faster, more effective bone healing. In the present work, the finite element and statistical approach was used to optimize the geometrical parameters of the implant plate made of SS 316L steel and Ti6Al4V alloy. A 3D finite element model was developed for analyzing the stresses and deformation, and implant plates were manufactured to validate the results with the help of an experiment conducted on the universal testing machine. A strong correlation was observed between the experimental and predicted results, with an average error of 8.6 % and 8.55 % for SS316L and Ti6Al4V alloy, respectively. Further, using the signal-to-noise ratio for the minimum stress condition was applied to identify the optimum parameters of the plate. Finally, regression models were developed to predict the stresses generated in SS316L and Ti6Al4V alloy plates with different input conditions. The statistical model helps us to develop the relation between different geometrical parameters of the Tibia implant plate. As determined by the present work, the parameter most influencing is implant plate length. This outcome will be used to select the implant for a specific patient, resulting in a reduction in implant failure post-surgery.

show abstract

The comparison of stress and strain between custom-designed bone plates (CDBP) and locking compression plate (LCP) for distal femur fracture

Cited by 5 publications

References 32 publications

Biomechanical design optimization of distal femur locked plates: A review

Biomechanical design optimization of distal femur locked plates: A review

Design considerations for patient-specific bone fixation plates: a literature review

Finite element analysis and optimization studies on tibia implant of SS 316L steel and Ti6Al4V alloy

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