Fit optimisation of a distal medial tibia plate

Abstract

An iterative method for the fit optimisation of a pre-contoured fracture fixation plate for a given bone data set is presented. Both plate shape optimisation and plate fit quantification are conducted in a virtual environment utilising computer graphical methods and 3D bone and plate models. Two optimised shapes of the undersurface of an existing distal medial tibia plate were generated based on a dataset of 45 3D bone models reconstructed from computed tomography image data of Japanese tibiae. The existing plate shape achieved an anatomical fit on 13% of tibiae from the dataset. Modified plate 1 achieved an anatomical fit for 42% and modified plate 2 a fit for 67% of the bones. If either modified plate 1 or plate 2 is used, then the anatomical fit can be increased to 82% for the same dataset. Issues pertaining to any further improvement in plate fit/shape are discussed.

Passform eines neuen auf Basis einer anatomischen Knochendatenbank entwickelten Klavikula-Osteosyntheseplattensystems (VariAx Clavicle) im Vergleich zu individuell von Chirurgen gebogenen Rekonstruktionsplatten

“…Im Rahmen der weiteren wissenschaftlichen Analyse müssen Faktoren wie Pseudarthroserate, funktionelle Ergebnisse, Schmerz-Scores, Lebensqualität und kosmetische Aspekte berücksichtigt werden [23]. In der Vergangenheit hat sich bei anatomisch vorgeformten Implantaten im Bereich der Tibia eine hohe Passungenauigkeit gezeigt [5,18]. Auch bei den hier untersuchten Klavikulaplatten zeigte sich, dass sich diese hohe Passgenauigkeit auch bei randomisiert ausge- Plate fit of a novel clavicula plate system (VariAx Clavicle) developed using a CT-based anatomical bone database compared to reconstruction plates individually formed by surgeons Abstract Background.…”

New Design Process for Anatomically Enhanced Osteosynthesis Plates

“…With regard to aspects related to the surgical procedure itself, use of anatomically enhanced plate designs may allow for increased opportunities for the use of minimally invasive operative techniques . Furthermore, such plates require little to no intra‐operative bending, which is advantageous as bending has the potential to decrease the mechanical stability of the plate, which may result in an increased risk of implant failure . Additionally, a well‐shaped plate can be used as a template to realign the fracture parts prior to surgical fixation …”

“…Furthermore, such plates require little to no intra‐operative bending, which is advantageous as bending has the potential to decrease the mechanical stability of the plate, which may result in an increased risk of implant failure . Additionally, a well‐shaped plate can be used as a template to realign the fracture parts prior to surgical fixation .…”

“…A number of post‐operative benefits associated with the utilization of anatomically enhanced osteosynthesis plates have also been observed. It has been reported that the mechanical stability of the plate‐bone construct may benefit from high levels of uniformity of plate‐to‐bone contact across the entire plate region because stress is more evenly distributed . Potential risk of malreduction caused by contour mismatch between plate and bone surface has also been reported .…”

“…Potential risk of malreduction caused by contour mismatch between plate and bone surface has also been reported . Anatomically compliant plates may also allow for lower plate prominence, which may be beneficial when the plate is utilized in regions with little soft tissue coverage, such as the hand. Substantial plate prominence may also increase the risk of soft‐tissue irritations and impingement, and thus should be avoided when possible.…”