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Alito A, Fenga D, Tropeano G, Milardi D, Leonetti D, Migliorato A, Tisano A, D’Andrea D, Filardi V. Screw Stress Distribution in a Clavicle Fracture with Plate Fixation: A Finite Element Analysis. Bioengineering (Basel) 2023; 10:1402. [PMID: 38135993 PMCID: PMC10740883 DOI: 10.3390/bioengineering10121402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/27/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023] Open
Abstract
Clavicle midshaft fractures are mostly treated surgically by open internal reduction with a superior or anteroinferior plate and screws or by intramedullary nailing. Screw positioning plays a critical role in determining the stress distribution. There is a lack of data on the screw position and the appropriate number of cortices required for plate fixation. The aim of this study is to evaluate the mechanical behavior of an anterior plate implanted in a fractured bone subjected to 120° of lateral elevation compared to a healthy clavicle using numerical simulations. Contact forces and moments used were obtained from literature data and applied to the healthy and fractured finite element models. Stresses of about 9 MPa were found on the healthy clavicle, while values of about 15 MPa were calculated on the plate of the fractured one; these stress peaks were reached at about 30° and 70° of elevation when the stress shielding on the clavicle sums all the three components of the solicitation: compression, flexion, and torsion. The stress distribution in a clavicle fracture stabilized with plates and screws is influenced by several factors, including the plate's position and design, the type of screw, and the biomechanical forces applied during movements.
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Affiliation(s)
- Angelo Alito
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, 98125 Messina, Italy; (A.A.); (G.T.); (D.M.); (D.L.); (A.M.)
| | - Domenico Fenga
- Department of Orthopaedics and Traumatology, University Hospital A.O.U. “G. Martino”, 98125 Messina, Italy;
| | - Giada Tropeano
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, 98125 Messina, Italy; (A.A.); (G.T.); (D.M.); (D.L.); (A.M.)
| | - Demetrio Milardi
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, 98125 Messina, Italy; (A.A.); (G.T.); (D.M.); (D.L.); (A.M.)
| | - Danilo Leonetti
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, 98125 Messina, Italy; (A.A.); (G.T.); (D.M.); (D.L.); (A.M.)
| | - Alba Migliorato
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, 98125 Messina, Italy; (A.A.); (G.T.); (D.M.); (D.L.); (A.M.)
| | - Adriana Tisano
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy;
| | - Danilo D’Andrea
- Department of Engineering, University of Messina, 98158 Messina, Italy;
| | - Vincenzo Filardi
- D.A. Scientific Research and Internationalization, University of Messina, 98121 Messina, Italy
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