The Effects of Bone Screw Configurations on the Interfragmentary Movement in a Long Bone Fixed by a Limited Contact Locking Compression Plate

Nourisa, Jalil; Baseri, Amin; Sudak, L. J.; Rouhi, Gholamreza

doi:10.4236/jbise.2015.89055

Cited by 14 publications

(7 citation statements)

References 40 publications

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“…Furthermore, modulus of elasticity of implant, plate thickness, and screw configuration were found as three dominant physical and mechanical factors, which strongly encourage the secondary healing pathway. These findings are consistent with previous studies which emphasized the individual importance of each of these parameters on bone healing 50,51 …”

Section: Discussionsupporting

confidence: 93%

Osteosynthesis of diaphyseal tibia fracture with locking compression plates: A numerical investigation using Taguchi and ANOVA

Mohandes

Tahani

Rouhi

2021

Numer Methods Biomed Eng

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Performance of the locking compression plate (LCP) is a multifactorial function. The control parameters of plating, such as geometries, material properties, and physical constraints of the LCP components, affect basic functions associated with the bone fixation, including the extent of stress shielding and subsequent bone remodeling, strength and stability of the bone‐LCP construct, and performance of secondary bone healing. The main objectives of this research were as follows: (1) to find the appropriate values of control parameters of an LCP construct to achieve the optimized performance throughout bone healing; and (2) to unravel relationships between LCP parameters and the LCP's performance. Different values for the plate/screw modulus of elasticity (E), plate width (W), plate thickness (T), screw diameter (D), bone‐plate offset (O), and screw configuration (C), as six control parameters, were considered at five different levels. Taguchi method was adopted to create trial combinations of control parameters and determining the best set of parameters, which can optimize the overall performance of the LCP. All design cases were analyzed using the finite element method. The optimal set of control parameters consisting of 150 GPa, 12 mm, 4 mm, 5.5 mm, 2 mm, and 123,678 were determined for E, W, T, D, O, and C, respectively. Furthermore, ANOVA was used to rank the most influential parameters on each function of the LCP fixation. In the overall performance of the LCP fixation, E, D, T, C, W, and O showed a contribution percentage of 46%, 22%, 10%, 11%, 8%, and 3%, respectively.

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Section: Discussionsupporting

confidence: 93%

Osteosynthesis of diaphyseal tibia fracture with locking compression plates: A numerical investigation using Taguchi and ANOVA

Mohandes

Tahani

Rouhi

2021

Numer Methods Biomed Eng

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“…Furthermore, the transcortical bone contact modelled in that study would produce high interfragmentary strain, initiating bone resorption at the fracture gap. [35][36][37][38] The consequent gap widening, necessary to reduce interfragmentary strain to levels where fibrous tissue could begin to form, could be expected to prolong fracture healing and promote further plate deformation. In such a situation, successful healing could only occur if fracture biology in that case was powerful enough to produce a healing time that was within the fatigue life and capacity of the implant.…”

Section: Discussionmentioning

confidence: 99%

Effect of Plate Type and Working Length on a Synthetic Compressed Juxta-Articular Fracture Model

et al. 2020

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Objective This investigation compared the biomechanical properties of a 2.0 mm locking compression notched head T-plate (NHTP) and 2.0 mm straight locking compression plate (LCP), in a compressed, short, juxta-articular fragment fracture model. Methods Two different screw configurations were compared for the NHTP and LCP, modelling short (configuration 1) and long working length (configuration 2). Constructs were tested in compression, perpendicular and tension four-point bending and torsion. Plate surface strain was measured at 12 regions of interest using three-dimensional digital image correlation. Stiffness and strain were compared. Results The LCP was stiffer than the NHTP in all three planes of bending (p < 0.05). The NHTP was stiffer than the LCP in torsion (p < 0.05). The NHTP had greater strain than the LCP during compression bending and torsion (p < 0.0005). The short working length NHTP was stiffer in all three planes of bending and in torsion (p < 0.05) than the longer working length. The short working length LCP was stiffer in compression bending and in torsion (p < 0.05) than the longer working length. The long working length showed greater strain than the short working length at multiple regions of interest. Conclusion In this experimental model of a compressed transverse fracture with a juxta-articular 9 mm fragment, a 2.0 mm LCP with two hybrid screws in the short fragment was stiffer than a 2.0 mm NHTP with three locking screws in the short fragment in three planes of bending but not torsion. Extending the working length of each construct reduced construct stiffness and increased plate strain.

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“…Zhang et al [11] used FEM to explore the distributions of different threaded holes on the locking plate, but different configurations of the screws were not studied. Nourisa et al [12] used FEM to investigate the influence of screws number and position on the interfragmentary strain of LCP-femur system for a midshaft fracture. Heyland et al [13] found that semirigid screws could change plate working length to control interfragmentary movement for locking plate fixation at the distal femur.…”

Section: Introductionmentioning

confidence: 99%

Finite Element- and Design of Experiment-Derived Optimization of Screw Configurations and a Locking Plate for Internal Fixation System

Sheng

Fang

et al. 2019

Computational and Mathematical Methods in Medicine

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Objectives. The optimization for the screw configurations and bone plate parameters was studied to improve the biomechanical performances such as reliable internal fixation and beneficial callus growth for the clinical treatment of femoral shaft fracture. Methods. The finite element analysis (FEA) of internal fixation system under different screw configurations based on the orthogonal design was performed and so was for the different structural parameters of the locking plate based on the combination of uniform and orthogonal design. Moreover, orthogonal experiment weight matrixes for four evaluation indexes with FEA were analyzed. Results. The analytical results showed the optimal scheme of screw configuration was that screws are omitted in the thread holes near the fracture site, and single cortical screws are used in the following holes to the distal end, while the double cortical screws are fixed in thread holes that are distal to the fracture; in the other words, the length of the screws showed an increasing trend from the fracture site to the distal end in the optimized configuration. The plate structure was optimized when thread holes gap reached 13 mm, with a width of 11 mm and 4.6 mm and 5 mm for thickness and diameter of the screw, respectively. The biomechanical performance of the internal fixation construct was further improved by about 10% based on the optimal strain range and lower stress in the internal fixation system. Conclusions. The proposed orthogonal design and uniform design can be used in a more efficient way for the optimization of internal fixation system, which can reduce the simulation runs to about 10% compared with comprehensive test, and the methodology can be also used for other types of fractures to achieve better internal fixation stability and optimal healing efficiency, which may provide a method for an orthopedist in choosing the screw configurations and parameters for internal fixation system in a more efficient way.

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The Effects of Bone Screw Configurations on the Interfragmentary Movement in a Long Bone Fixed by a Limited Contact Locking Compression Plate

Cited by 14 publications

References 40 publications

Osteosynthesis of diaphyseal tibia fracture with locking compression plates: A numerical investigation using Taguchi and ANOVA

Osteosynthesis of diaphyseal tibia fracture with locking compression plates: A numerical investigation using Taguchi and ANOVA

Effect of Plate Type and Working Length on a Synthetic Compressed Juxta-Articular Fracture Model

Finite Element- and Design of Experiment-Derived Optimization of Screw Configurations and a Locking Plate for Internal Fixation System

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