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Thin patient‐specific clavicle fracture fixation plates can mechanically outperform commercial plates: An in silico approach
Author(s) -
Vancleef Sanne,
Wesseling Mariska,
Duflou Joost R.,
Nijs Stefaan,
Jonkers Ilse,
Vander Sloten Jos
Publication year - 2022
Publication title -
journal of orthopaedic research®
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.25178
Subject(s) - clavicle , contouring , fixation (population genetics) , materials science , stiffness , fracture (geology) , reduction (mathematics) , implant , biomedical engineering , orthodontics , surgery , medicine , composite material , computer science , geometry , mathematics , population , computer graphics (images) , environmental health
Current fixation plates used to operatively stabilize clavicular fractures are suboptimal, leading to reoperation rates up to 53%. Plate irritation, which can be caused by a poor geometric fit and plate thickness, has been found to be an important factor for reoperation. Moreover, muscle attachment sites (MAS) have to be detached occasionally. To improve current surgical clavicle fracture treatment with plate osteosynthesis, a change in plate design is required. The goal of this study was to design a patient‐specific clavicle fracture fixation plate that includes geometrical optimization and stiffness determination. Its biomechanical performance has been compared with a commercial plate by examining the geometric fit, anatomical outline, stresses and interfragmentary motion using a finite element analysis with physiological loading and boundary conditions. Evaluation showed a better geometrical fit of the patient‐specific plate as well as an improved fracture reduction. Displacements between fracture fragments were lower in case of the patient‐specific plate, both when a fracture gap and no fracture gap were present. Results indicate a superior mechanical performance in terms of all investigated outcomes of the patient‐specific plate compared to the commercial plate, while better aligning with the patient‐specific geometry and without the need for MAS release. Due to the patient‐specific geometry and reduced thickness, these fixation plates are expected to decrease the operation time, as intraoperative contouring will become irrelevant, and to decrease reoperation rates as implant irritation will be minimized.