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

Brouwer de Koning, S. G.; de Winter, N.; Moosabeiki, V.; Mirzaali, M. J.; Berenschot, A.; Witbreuk, M. M. E. H.; Lagerburg, V.

doi:10.1007/s11517-023-02900-4

Cited by 4 publications

(2 citation statements)

References 92 publications

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“…In this study, we found a statistically significant interaction between the CSA and BM. This finding collaborates findings of another study investigating the relationship between AdhFix plate thickness and biomechanical performance indicating that increasing plate width also contributes to increased biomechanical performance [10,14]. When adjusted for CSA in this study, only the surgeons with the highest and lowest BM, surgeon 2 and surgeon 3, respectively, remained statistically significantly different from each other.…”

Section: Discussionsupporting

confidence: 90%

“…The advantage of this innovative technique is that it enables surgeons to create a fracture-specific osteosynthesis in situ, potentially optimizing bone healing [14][15][16]. However, the flexibility inherent in this approach also means that variations in size, shape, and biomechanical properties between each osteosynthesis are to be expected.…”

Section: Introductionmentioning

confidence: 99%

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Biomechanical Variability and Usability of a Novel Customizable Fracture Fixation Technique

Colding-Rasmussen,

Schwarzenberg,

Horstmann

et al. 2023

Bioengineering

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A novel in situ customizable osteosynthesis technique, Bonevolent™ AdhFix, demonstrates promising biomechanical properties under the expertise of a single trained operator. This study assesses inter- and intra-surgeon biomechanical variability and usability of the AdhFix osteosynthesis platform. Six surgeons conducted ten osteosyntheses on a synthetic bone fracture model after reviewing an instruction manual and completing one supervised osteosynthesis. Samples underwent 4-point bending tests at a quasi-static loading rate, and the maximum bending moment (BM), bending stiffness (BS), and AdhFix cross-sectional area (CSA: mm²) were evaluated. All constructs exhibited a consistent appearance and were suitable for biomechanical testing. The mean BM was 2.64 ± 0.57 Nm, and the mean BS was 4.35 ± 0.44 Nm/mm. Statistically significant differences were observed among the six surgeons in BM (p < 0.001) and BS (p = 0.004). Throughout ten trials, only one surgeon demonstrated a significant improvement in BM (p < 0.025), and another showed a significant improvement in BS (p < 0.01). A larger CSA corresponded to a statistically significantly higher value for BM (p < 0.001) but not for BS (p = 0.594). In conclusion, this study found consistent biomechanical stability both across and within the surgeons included, suggesting that the AdhFix osteosynthesis platform can be learned and applied with minimal training and, therefore, might be a clinically viable fracture fixation technique. The variability in BM and BS observed is not expected to have a clinical impact, but future clinical studies are warranted.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Biomechanical Variability and Usability of a Novel Customizable Fracture Fixation Technique

Colding-Rasmussen,

Schwarzenberg,

Horstmann

et al. 2023

Bioengineering

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3D printed patient-specific fixation plates for the treatment of slipped capital femoral epiphysis: Topology optimization vs. conventional design

Moosabeiki,

de Winter,

Cruz Saldivar

et al. 2023

Journal of the Mechanical Behavior of Biomedical Materials

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Optimum design of a biodegradable implant for femoral shaft fracture fixation using finite element method.

Taghipour,

Tahami,

Allahverdizadeh

2024

Preprint

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Recent developments in biodegradable implant technology have expanded its use in several medical fields, such as orthopedics, cardiology, dentistry, and tissue engineering. Degradable bone-fixing implants have shown favorable results among others. Degradable implants, consisting of a plate and screws, provide the advantage of completely degrading after efficaciously supporting the broken bone for the required duration. They may even provide nutrients that accelerate the healing process while ensuring sufficient mechanical stability. Magnesium alloys are being considered by researchers as promising options for bone implants due to their natural degradability, good biocompatibility, and ability to lower the chances of long-term complications. The rapid corrosion rate and inferior mechanical properties of magnesium relative to non-biodegradable materials are significant challenges in their clinical usage as implant material. This leads to a loss of structural strength before the broken bone completely heals. Hence This article mainly concentrates on the design of a biodegradable implant plate for a femoral shaft fracture in the walking cycle, considering the plate's dimension, number of screws, biodegradation rate, and sufficient mechanical stability. Using the results of the numerical analyses, the safe zone of the implant plate design is determined based on the implant plate stress and the total displacement of the femur bone. Then, the optimum topology of the plate and appropriate number of screws are determined.

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

Cited by 4 publications

References 92 publications

Biomechanical Variability and Usability of a Novel Customizable Fracture Fixation Technique

Biomechanical Variability and Usability of a Novel Customizable Fracture Fixation Technique

3D printed patient-specific fixation plates for the treatment of slipped capital femoral epiphysis: Topology optimization vs. conventional design

Optimum design of a biodegradable implant for femoral shaft fracture fixation using finite element method.

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