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Li Y, Lu F, Yi P, Zou Z, Zhang X, Zhang J. Computational analysis of the biomechanical stability of internal fixation of the lateral tibial plateau fracture: A mechanical stability study. Proc Inst Mech Eng H 2024:9544119241272782. [PMID: 39180409 DOI: 10.1177/09544119241272782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2024]
Abstract
The selection of internal fixation as the primary fixation modality for the patient is one of the challenges for the surgeon treating the patient in question. A model of the lateral tibial plateau fracture was established. Three different configurations of internal fixators namely L bone plate, T bone plate, and screw-washer were analyzed. Three stages after surgery were simulated to assess the displacement of bone plates, screws, washers, and the stress shielding ratio in the fracture area.At three stages after surgery, the T bone plate showed better stability for patients during rehabilitation compared with the remaining two schemes, and the screw-washer scheme was the least stable due to the larger internal fixation displacement and stress shielding ratio in the fracture area. In contrast, the L bone plate scheme showed better stability in the early stages after surgery but was second only to the screw-washer scheme in the middle and late stages after surgery. The T bone plate showed better stability and became a new selection for surgeons to treat related patients. At three stages after surgery, the T bone plate has better biomechanical stability compared to the L bone plate and screw-washer schemes.
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Affiliation(s)
- Yafeng Li
- School of Mechanical Engineering, Tiangong University, Tianjin, China
- Tianjin Key Laboratory of Advanced Mechatronics Equipment Technology, Tiangong University, Tianjin, China
| | - Fengyuan Lu
- School of Mechanical Engineering, Tiangong University, Tianjin, China
- Tianjin Key Laboratory of Advanced Mechatronics Equipment Technology, Tiangong University, Tianjin, China
| | - Peng Yi
- School of Mechanical Engineering, Tiangong University, Tianjin, China
- Tianjin Key Laboratory of Advanced Mechatronics Equipment Technology, Tiangong University, Tianjin, China
| | - Zichun Zou
- School of Mechanical Engineering, Tiangong University, Tianjin, China
- Tianjin Key Laboratory of Advanced Mechatronics Equipment Technology, Tiangong University, Tianjin, China
| | - Xi Zhang
- Traumatic Orthopedics, Tianjin Hospital, Tianjin, China
| | - Jing Zhang
- Department of Mechanical and Energy Engineering, Indiana University-Purdue University Indianapolis, IN, USA
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Yan Z, Zou C, Kenmegne GR, Pan X, Ghimire N, Silva KMN, Fang Y. Newly designed plate for the treatment of posterolateral tibial plateau fractures: a finite element analysis. J Orthop Surg Res 2024; 19:201. [PMID: 38532441 DOI: 10.1186/s13018-024-04686-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 03/16/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND This study investigated the biomechanical properties of a new plate used for the treatment of posterolateral tibial plateau fractures using finite element analysis. METHODS The study groups were as follows: group PM, model of the new plate with posteromedial tibial plateau fracture; group PL, model of the new plate with posterolateral tibial plateau fracture; and group PC, model of the new plate with posterior tibial plateau fracture. We used two loading modes: uniform loading on the entire plateau, and loading on the posterior plateau. Data such as the displacement of the fracture and distribution of stress on the new plate and screws were recorded and analyzed. RESULTS When the whole plateau was loaded, the displacement of fractures in groups PM, PL, and PC were 0.273, 0.114, and 0.265 mm, respectively. The maximum stresses on the plates in groups PM, PL, and PC were 118.131 MPa, 44.191 MPa, and 115.433 MPa. The maximum stresses on the screws in Groups PM, PL, and PC were 166.731, 80.330, and 164.439 MPa, respectively. When the posterior tibial plateau was loaded, the displacement of the fractures in groups PM, PL, and PC was 0.410, 0.213, and 0.390 mm, respectively. The maximum stresses on the plates in groups PM, PL, and PC were 194.012 MPa, 72.806 MPa, and 185.535 MPa. The maximum stresses on the screws in Groups PM, PL, and PC were 278.265, 114.839, and 266.396 MPa, respectively. CONCLUSION The results of this study revealed that titanium plates have good fixation effects in all groups; therefore, the use of the new plate for posterolateral tibial plateau fractures appears to be safe and valid.
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Affiliation(s)
- Zhaokui Yan
- Department of Orthopedics, West China Hospital of Sichuan University, Chengdu, 610041, China
- Trauma center, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Chang Zou
- Department of Orthopedics, West China Hospital of Sichuan University, Chengdu, 610041, China
- Trauma center, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Guy Romeo Kenmegne
- Department of Orthopedics, West China Hospital of Sichuan University, Chengdu, 610041, China
- Trauma center, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Xuelin Pan
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Nawin Ghimire
- Department of Orthopedics, West China Hospital of Sichuan University, Chengdu, 610041, China
- Trauma center, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Kuruwitage Manthi Nihara Silva
- Department of Orthopedics, West China Hospital of Sichuan University, Chengdu, 610041, China
- Trauma center, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Yue Fang
- Department of Orthopedics, West China Hospital of Sichuan University, Chengdu, 610041, China.
- Trauma center, West China Hospital of Sichuan University, Chengdu, 610041, China.
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Wei G, Niu X, Li Y, Chang T, Zhang J, Wang H, Li X, He Y, Wang R, Tian F, Xu Y. Biomechanical analysis of internal fixation system stability for tibial plateau fractures. Front Bioeng Biotechnol 2023; 11:1199944. [PMID: 37388773 PMCID: PMC10303893 DOI: 10.3389/fbioe.2023.1199944] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 06/06/2023] [Indexed: 07/01/2023] Open
Abstract
Background: Complex bone plateau fractures have been treated with bilateral plate fixation, but previous research has overemphasized evaluating the effects of internal fixation design, plate position, and screw orientation on fracture fixation stability, neglecting the internal fixation system's biomechanical properties in postoperative rehabilitation exercises. This study aimed to investigate the mechanical properties of tibial plateau fractures after internal fixation, explore the biomechanical mechanism of the interaction between internal fixation and bone, and make suggestions for early postoperative rehabilitation and postoperative weight-bearing rehabilitation. Methods: By establishing the postoperative tibia model, the standing, walking and running conditions were simulated under three axial loads of 500 N, 1000 N, and 1500 N. Accordingly, finite element analysis (FEA) was performed to analyze the model stiffness, displacement of fractured bone fragments, titanium alloy plate, screw stress distribution, and fatigue properties of the tibia and the internal fixation system under various conditions. Results: The stiffness of the model increased significantly after internal fixation. The anteromedial plate was the most stressed, followed by the posteromedial plate. The screws at the distal end of the lateral plate, the screws at the anteromedial plate platform and the screws at the distal end of the posteromedial plate are under greater stress, but at a safe stress level. The relative displacement of the two medial condylar fracture fragments varied from 0.002-0.072 mm. Fatigue damage does not occur in the internal fixation system. Fatigue injuries develop in the tibia when subjected to cyclic loading, especially when running. Conclusion: The results of this study indicate that the internal fixation system tolerates some of the body's typical actions and may sustain all or part of the weight early in the postoperative period. In other words, early rehabilitative exercise is recommended, but avoid strenuous exercise such as running.
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Affiliation(s)
- Guoqiang Wei
- Department of Rehabilitation Medicine, Changzhi Medical College Affiliated Changzhi People’s Hospital, Changzhi, China
| | - Xiaofen Niu
- Department of Rehabilitation Medicine, Changzhi Medical College Affiliated Changzhi People’s Hospital, Changzhi, China
| | - Yuan Li
- Department of Orthopedics, Changzhi Medical College Affiliated Peace Hospital, Changzhi, China
| | - Tingjie Chang
- Department of Orthopedics, Changzhi Medical College Affiliated Peace Hospital, Changzhi, China
| | - Jianfang Zhang
- Department of Rehabilitation Medicine, Changzhi Medical College Affiliated Changzhi People’s Hospital, Changzhi, China
| | - Haiyan Wang
- Department of Anatomy, School of Basic Medical Sciences, Inner Mongolia Medical University, Hohhot, China
| | - Xiaohe Li
- Department of Anatomy, School of Basic Medical Sciences, Inner Mongolia Medical University, Hohhot, China
| | - Yujie He
- Department of Anatomy, School of Basic Medical Sciences, Inner Mongolia Medical University, Hohhot, China
| | - Ruijiang Wang
- Department of Orthopedics, Changzhi Second People’s Hospital, Changzhi, China
| | - Fei Tian
- Department of Health Management, Changzhi Medical College, Changzhi, China
- Department of Rehabilitation Medicine, Changzhi Medical College Affiliated Peace Hospital, Changzhi, China
| | - Yangyang Xu
- Beijing Key Laboratory for Design and Evaluation Technology of Advanced Implantable and Interventional Medical Devices, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
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Ferre LS, Di Nisio FG, Mendonça CJA, Belo IM. Comparative analysis of tibial plateau fracture osteosynthesis: A finite element study. J Mech Behav Biomed Mater 2022; 134:105392. [DOI: 10.1016/j.jmbbm.2022.105392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 02/12/2022] [Accepted: 07/19/2022] [Indexed: 11/16/2022]
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Forna N, Munteanu F, Moldoveanu S, Savin L, Sîrbu P, Puha B. Treatment of C1.1 (AO‑41) tibial plateau fracture: A finite element analysis of single medial, lateral and dual plating. Exp Ther Med 2022; 23:198. [PMID: 35126701 PMCID: PMC8794547 DOI: 10.3892/etm.2022.11121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 10/26/2021] [Indexed: 11/06/2022] Open
Abstract
Bicondylar tibial plateau fractures pose many challenges in surgical treatment. The aim of the present study was to analyze three methods of reduction, single medial, single lateral, and dual plating, for the treatment of a bicondylar tibial plateau fracture, through finite element analysis (FEA). A simple metaphyseal fracture, type C1.1 (AO-41) was modeled on a CT-derived 3D model of the knee. Lateral and medial proximal tibial polyaxial plates with screws were modeled and placed accordingly for the three methods of reduction. Simulation of physiological type loading corresponding to the maximal weight acceptance phase during a slow walking gait cycle was performed using FEA. Values of stress and strain were recorded near the fracture lines. Dual plating provided a decrease of stress and strain in the tibial plateau area. However, the differences in the values among the three cases were small. The stress concentration areas were located in the vicinity of the fracture, predominantly in the area of the tibial plateau. Considering the limitations of the present study, the results revealed that dual plating leads to smaller stress and strain values near the fracture lines in the tibial plateau area. However, values obtained for single lateral plating are close in range. Considering the complexity of the surgical approach for dual plating, single lateral plating may be a solution for good reduction with fewer surgical risks and complications. Further studies on the C1.1 fracture (AO-41) are needed to analyze the complex issue of reducing and stabilizing such a fracture and to characterize the postoperative state while providing predictable parameters for an optimal result.
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Affiliation(s)
- Norin Forna
- Department of Surgery II, Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Florin Munteanu
- Department of Biomedical Sciences, Faculty of Medical Bioengineering, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700454 Iasi, Romania
| | - Sînziana Moldoveanu
- Department of Biomedical Sciences, Faculty of Medical Bioengineering, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700454 Iasi, Romania
| | - Liliana Savin
- Department of Surgery II, Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Paul Sîrbu
- Department of Surgery II, Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Bogdan Puha
- Department of Surgery II, Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
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Oefner C, Herrmann S, Kebbach M, Lange HE, Kluess D, Woiczinski M. Reporting checklist for verification and validation of finite element analysis in orthopedic and trauma biomechanics. Med Eng Phys 2021; 92:25-32. [PMID: 34167708 DOI: 10.1016/j.medengphy.2021.03.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 02/11/2021] [Accepted: 03/29/2021] [Indexed: 10/21/2022]
Abstract
Finite element analysis (FEA) has become a fundamental tool for biomechanical investigations in the last decades. Despite several existing initiatives and guidelines for reporting on research methods and results, there are still numerous issues that arise when using computational models in biomechanical investigations. According to our knowledge, these problems and controversies lie mainly in the verification and validation (V&V) process as well as in the set-up and evaluation of FEA. This work aims to introduce a checklist including a report form defining recommendations for FEA in the field of Orthopedic and Trauma (O&T) biomechanics. Therefore, a checklist was elaborated which summarizes and explains the crucial methodologies for the V&V process. In addition, a report form has been developed which contains the most important steps for reporting future FEA. An example of the report form is shown, and a template is provided, which can be used as a uniform basis for future documentation. The future application of the presented report form will show whether serious errors in biomechanical investigations using FEA can be minimized by this checklist. Finally, the credibility of the FEA in the clinical area and the scientific exchange in the community regarding reproducibility and exchangeability can be improved.
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Affiliation(s)
- Christoph Oefner
- Center for Research on Musculoskeletal Systems, Faculty of Medicine, Leipzig University, Semmelweisstrasse 14, 04103 Leipzig, Germany; Department of Orthopaedic Surgery, Traumatology and Plastic Surgery, Leipzig University, Liebigstrasse 18, 04103 Leipzig, Germany; Faculty of Engineering Sciences, Leipzig University of Applied Sciences, Karl-Liebknecht-Strasse 134, 04277 Leipzig, Germany.
| | - Sven Herrmann
- Institute for Biomechanics, BG Unfallklinik, Prof.-Küntscher-Strasse 8, 82418 Murnau am Staffelsee, Germany; Institute for Biomechanics, Paracelsus Medical University Salzburg (Austria), Prof.-Küntscher-Strasse 8, 82418 Murnau am Staffelsee, Germany
| | - Maeruan Kebbach
- Biomechanics and Implant Technology Research Laboratory, Department of Orthopaedics, Rostock University Medical Center, Doberaner Strasse 142, 18057 Rostock, Germany
| | - Hans-E Lange
- Biomechanics and Implant Technology Research Laboratory, Department of Orthopaedics, Rostock University Medical Center, Doberaner Strasse 142, 18057 Rostock, Germany
| | - Daniel Kluess
- Biomechanics and Implant Technology Research Laboratory, Department of Orthopaedics, Rostock University Medical Center, Doberaner Strasse 142, 18057 Rostock, Germany
| | - Matthias Woiczinski
- Department of Orthopaedics, Physical Medicine and Rehabilitation, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany
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