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Biomechanical analysis of combi-hole locking compression plate during fracture healing: A numerical study of screw configuration

Li, Zeyang, Pollard, Stuart, Smith, Gemma, Deshmukh, Subodh and Ding, Ziyun 2024. Biomechanical analysis of combi-hole locking compression plate during fracture healing: A numerical study of screw configuration. Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 238 (3) , pp. 313-323. 10.1177/09544119241229157

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Locking compression plates (LCPs) have become a widely used option for treating femur bone fractures. However, the optimal screw configuration with combi-holes remains a subject of debate. The study aims to create a time-dependent finite element (FE) model to assess the impacts of different screw configurations on LCP fixation stiffness and healing efficiency across four healing stages during a complete fracture healing process. To simulate the healing process, we integrated a time-dependent callus formation mechanism into a FE model of the LCP with combi-holes. Three screw configuration parameters, namely working length, screw number, and screw position, were investigated. Increasing the working length negatively affected axial stiffness and healing efficiency (p < 0.001), while screw number or position had no significant impact (p > 0.01). The time-dependent model displayed a moderate correlation with the conventional time-independent model for axial stiffness and healing efficiency (ρ ≥ 0.733, p ≤ 0.025). The highest healing efficiency (95.2%) was observed in screw configuration C125 during the 4–8-week period. The results provide insights into managing fractures using LCPs with combi-holes over an extended duration. Under axial compressive loading conditions, the use of the C125 screw configuration can enhance callus formation during the 4–12-week period for transverse fractures. When employing the C12345 configuration, it becomes crucial to avoid overconstraint during the 4–8-week period.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Engineering
Publisher: SAGE Publications
ISSN: 0954-4119
Date of First Compliant Deposit: 5 March 2024
Last Modified: 29 Apr 2024 13:40

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