Biomechanical analysis of internal fixation system stability for tibial plateau fractures

Frontiers in Bioengineering and Biotechnology

Bioengineering and Biotechnology

Yangyang Xu¹  Xiaohe Li²  Yujie He²  Haiyan Wang²  Fei Tian³  Tingjie Chang⁴  Yuan Li⁴  Ruijiang Wang⁵  Xiaofen Niu⁶  Jianfang Zhang⁶  Guoqiang Wei⁶ 

[1] Beijing Key Laboratory for Design and Evaluation Technology of Advanced Implantable and Interventional Medical Devices, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China;Department of Anatomy, School of Basic Medical Sciences, Inner Mongolia Medical University, Hohhot, China;Department of Health Management, Changzhi Medical College, Changzhi, China;Department of Rehabilitation Medicine, Changzhi Medical College Affiliated Peace Hospital, Changzhi, China;Department of Orthopedics, Changzhi Medical College Affiliated Peace Hospital, Changzhi, China;Department of Orthopedics, Changzhi Second People’s Hospital, Changzhi, China;Department of Rehabilitation Medicine, Changzhi Medical College Affiliated Changzhi People’s Hospital, Changzhi, China;

关键词: biomechanical study;    finite element analysis;    internal fixation;    tibial plateau fracture;    weight bearing;    interfragmentary motion;   

DOI  :  10.3389/fbioe.2023.1199944

 received in 2023-04-04, accepted in 2023-06-06,  发布年份 2023

来源: Frontiers

【 摘 要 】

Background: Complex bone plateau fractures have been treated with bilateral plate fixation, but previous research has overemphasized evaluating the effects of internal fixation design, plate position, and screw orientation on fracture fixation stability, neglecting the internal fixation system’s biomechanical properties in postoperative rehabilitation exercises. This study aimed to investigate the mechanical properties of tibial plateau fractures after internal fixation, explore the biomechanical mechanism of the interaction between internal fixation and bone, and make suggestions for early postoperative rehabilitation and postoperative weight-bearing rehabilitation.Methods: By establishing the postoperative tibia model, the standing, walking and running conditions were simulated under three axial loads of 500 N, 1000 N, and 1500 N. Accordingly, finite element analysis (FEA) was performed to analyze the model stiffness, displacement of fractured bone fragments, titanium alloy plate, screw stress distribution, and fatigue properties of the tibia and the internal fixation system under various conditions.Results: The stiffness of the model increased significantly after internal fixation. The anteromedial plate was the most stressed, followed by the posteromedial plate. The screws at the distal end of the lateral plate, the screws at the anteromedial plate platform and the screws at the distal end of the posteromedial plate are under greater stress, but at a safe stress level. The relative displacement of the two medial condylar fracture fragments varied from 0.002–0.072 mm. Fatigue damage does not occur in the internal fixation system. Fatigue injuries develop in the tibia when subjected to cyclic loading, especially when running.Conclusion: The results of this study indicate that the internal fixation system tolerates some of the body’s typical actions and may sustain all or part of the weight early in the postoperative period. In other words, early rehabilitative exercise is recommended, but avoid strenuous exercise such as running.

【 授权许可】

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Copyright © 2023 Wei, Niu, Li, Chang, Zhang, Wang, Li, He, Wang, Tian and Xu.