Strength analysis of clavicle fracture fixation devices and fixation techniques using finite element analysis with musculoskeletal force input

Abstract

In the cases, when clavicle fractures are treated with a fixation plate, opinions are divided about the best position of the plate, type of plate and type of screw units. Results from biomechanical studies of clavicle fixation devices are contradictory, probably partly because of simplified and varying load cases used in different studies. The anatomy of the shoulder region is complex, which makes it difficult and expensive to perform realistic experimental tests; hence, reliable simulation is an important complement to experimental tests. In this study, a method for finite element simulations of stresses in the clavicle plate and bone is used, in which muscle and ligament force data are imported from a multibody musculoskeletal model. The stress distribution in two different commercial plates, superior and anterior plating position and fixation including using a lag screw in the fracture gap or not, was compared. Looking at the clavicle fixation from a mechanical point of view, the results indicate that it is a major benefit to use a lag screw to fixate the fracture. The anterior plating position resulted in lower stresses in the plate, and the anatomically shaped plate is more stress resistant and stable than a regular reconstruction plate.

Will the Strength of the Clavicle Plate be Increased by Inserting Small Screws into the Empty Holes above the Fracture Site?

“…As previous studies [13,14], the screw hole above the fracture site is the weakest point in the superior clavicle locking plate for comminuted midshaft clavicle fracture, especially in the cantilever bending force. B model showed superior biomechanical property than A model under all loading conditions.…”

“…According to the study which was a FEA about clavicle fracture xation, the maximum stress in the precontoured superior reconstruction plate xation without lag screws occurred at the edge of screw holes above the fracture site [13]. Also other study revealed that the weakest point of the superior clavicle locking compression plate in comminuted midshaft clavicle fracture is the screw holes above fracture zone, especially in the cantilever bending force and therefore recommended a new design which is a superior locking plate without screw holes above fracture zone to prevent metal failure [14].…”

The Use of a Vibro-Acoustic Based Method to Determine the Composite Material Properties of a Replicate Clavicle Bone Model

“…In addition to implementing these updated models in vibration-based biomechanical research as stated above, vibration-validated clavicle FE models can also find their application in numerical orthopedic research applications, such as the assessment of clavicle fracture fixation treatments [4,[10][11][12][13][14][15]46], influence of patient-specific parameters on clavicle fractures [47] or analysis of stress shielding effects in clavicle fracture fixation treatments [16].…”

“…FE analysis offers the possibility to analyze biomechanical structures while controlling multiple parameters, such as loading/boundary conditions, geometry, material properties etc., contributing to a better insight in the studied problem. More specifically, FE models have found their merit in clavicle-related orthopedic research, such as the assessment of stress, strain and micro-motion distribution in clavicle fracture fixation treatments [4,[10][11][12][13][14][15] or the quantification of stress shielding around clavicle fracture fixation implants [16].…”

Tibia diafiz transvers kırığının plak-vida ile tespitinin sonlu elemanlar yöntemi ile analizi

“…Therefore, it was decided to use 3D FEM in this study to evaluate the analysis due to its various advantages, such as localizing the stresses on the plate, screws and in every region of the bone and realistic simulation of the plate and screws (7). The aim of stress analysis with FEM is to investigate the weak points when a structural deformation occurs on structures under a load (8,9).…”