Finite Element-Derived Surrogate Models of Locked Plate Fracture Fixation Biomechanics

Wee, Hwabok; Reid, J. Spence; Chinchilli, Vernon M.; Lewis, Gregory S.

doi:10.1007/s10439-016-1714-3

Cited by 20 publications

(14 citation statements)

References 29 publications

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“…Wee et al . developed a set of FE models of a diaphyseal midshaft fracture treated with a plate 41. Surrogate mathematical models were developed using multivariate regression to understand the relationships between different design parameters and implant performances (maximum stress in plate and screws, axial and shear strain, and axial, torsional and bending stiffness).…”

Section: Introductionmentioning

confidence: 99%

“…developed a set of FE models of a diaphyseal midshaft fracture treated with a plate. 41 Surrogate mathematical models were developed using multivariate regression to understand the relationships between different design parameters and implant performances (maximum stress in plate and screws, axial and shear strain, and axial, torsional and bending stiffness). Willing and Kim conducted parametric design optimisation of a total knee replacement where abrasive wear of the polyethylene insert was minimised under an ISO standard test for total knee replacement wear.…”

Section: Introductionmentioning

confidence: 99%

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Parametric Design Optimisation of Proximal Humerus Plates Based on Finite Element Method

et al. 2018

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Optimal treatment of proximal humerus fractures remains controversial. Locking plates offer theoretical advantages but are associated with complications in the clinic. This study aimed to perform parametric design optimisation of proximal humerus plates to enhance their mechanical performance. A finite element (FE) model was developed that simulated a two-part proximal humerus fracture that had been treated with a Spatial Subchondral Support (S3) plate and subjected to varus bending. The FE model was validated against in vitro biomechanical test results. The predicted load required to apply 5 mm cantilever varus bending was only 0.728% lower. The FE model was then used to conduct a parametric optimisation study to determine the orientations of inferomedial plate screws that would yield minimum fracture gap change (i.e. optimal stability). The feasible design space was automatically identified by imposing clinically relevant constraints, and the creation process of each FE model for the design optimisation was automated. Consequently, 538 FE models were generated, from which the obtained optimal model had 4.686% lower fracture gap change (0.156 mm) than that of the manufacturer’s standard plate. Whereas its screws were oriented towards the inferomedial region and within the range of neck-shaft angle of a healthy subject. The methodology presented in this study promises future applications in patient-specific design optimisation of implants for other regions of the human body.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Parametric Design Optimisation of Proximal Humerus Plates Based on Finite Element Method

et al. 2018

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“…Moazen et al 13 observed that configuration of screws had a greater effect on the quality of fixation than did the plate material. Wee et al 14 simulated the plate-screw fixation system so that the bone was modeled with a homogeneous cylinder; the results showed that the distance between the screws had a significant effect on the stresses of the plate and screws.…”

Section: Introductionmentioning

confidence: 99%

A multi-objective approach to optimize the weight and stress of the locking plates using finite element modeling

Rafiei

Nourani

Chizari

2021

Proc Inst Mech Eng H

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This paper aims to identify an optimum bone fracture stabilizer. For this purpose, three design variables including the ratio of the screw diameter to the plate width at three levels, the ratio of the plate thickness to the plate width at three levels, and the diameter of the bone at two levels were selected for analysis. Eighteen 3D verified finite element models were developed to examine the effects of these parameters on the weight, maximum displacement and maximum von Mises stress of the fixation structure. Considering the relations between the inputs and outputs using multivariate regression, a genetic algorithm was used to find the optimal choices. Results showed that the diameter of the bone and the amount of load applied on it did not have a significant effect on the normalized stresses on the structures. Furthermore, in all ratio of the plate thickness to the plate width, as the ratio of the screw diameter to the plate width increased, the amount of stress on the structure decreased. But, by further increasing the ratio of the screw diameter to the plate width, the amount of stress on the structure increased. On the other hand, by increasing the value of the ratio of the plate thickness to the plate width, the maximum amount of stress on the structure decreased. Finally, optimal solutions in terms of the weight and the maximum amount of stress on the structure were presented.

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“…The surgeon selects nail type, length, and diameter, as well as whether or not to use distal locking screw fixation. Though there may be multiple successful combinations for a given case, each configuration has a relatively higher risk of failure when compared to a theoretically optimal construct . In the case of the IM nail fixation, clinical failures are reported in up to 14% of patients via, most commonly, fixation screw bending and fatigue, cut‐out, and nail failure .…”

mentioning

confidence: 99%

“…Though there may be multiple successful combinations for a given case, each configuration has a relatively higher risk of failure when compared to a theoretically optimal construct. 5 In the case of the IM nail fixation, clinical failures are reported in up to 14% of patients 6 via, most commonly, fixation screw bending and fatigue, 7 cut-out, and nail failure. [8][9][10] Excessive interfragmentary motion at the fracture site resulting from instability can result in high strain and disrupt healing, leading to nonunion.…”

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confidence: 99%

Parametric Finite Element Analysis of Intramedullary Nail Fixation of Proximal Femur Fractures

Tucker

Wee

Fox

et al. 2019

Journal Orthopaedic Research

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Proximal femur fracture fixation with intramedullary nailing relies on stability at the fracture site and integrity of the fixation construct to achieve union. The biomechanics that dictate fracture site stability and implant stress depend on fracture type as well as implant features such as nail length, nail diameter, presence of distal fixation screws, and material composition of the implant. When deciding how to fix a fracture, surgeons have choices in these implant‐related design variables. This study models all combinations of a range of implant variables for nine standard AO/OTA proximal femur fractures using finite element analysis. Under simulated maximum load during gait, the maximum stress in the implant and screws as well as interfragmentary motions at the fracture site in the axial and shear directions were computed. The results were separated by fracture type to show the influence of each design variable on measured biomechanical outcomes. Filling the reamed canal with the largest fitting nail diameter reduced axial and shear interfragmentary motion for all fracture types. Nail length was less predictive of shear interfragmentary motion for most simulated fracture types than other construct variables. Furthermore, gapping at the fracture site predisposed the construct to higher implant stresses and larger interfragmentary motions. Clinical significance: Biomechanical outcomes from this computational study can aid in surgical decision‐making for optimizing hip fracture fixation with IM nailing. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2358–2366, 2019

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Finite Element-Derived Surrogate Models of Locked Plate Fracture Fixation Biomechanics

Cited by 20 publications

References 29 publications

Parametric Design Optimisation of Proximal Humerus Plates Based on Finite Element Method

Parametric Design Optimisation of Proximal Humerus Plates Based on Finite Element Method

A multi-objective approach to optimize the weight and stress of the locking plates using finite element modeling

Parametric Finite Element Analysis of Intramedullary Nail Fixation of Proximal Femur Fractures

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