Thin patient-specific clavicle fracture fixation plates can mechanically outperform commercial plates: An in silico approach

Sanne Vancleef*, Mariska Wesseling, Joost R. Duflou, Stefaan Nijs, Ilse Jonkers, Jos Vander Sloten

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

6 Citations (Scopus)

Abstract

Current fixation plates used to operatively stabilize clavicular fractures are suboptimal, leading to reoperation rates up to 53%. Plate irritation, which can be caused by a poor geometric fit and plate thickness, has been found to be an important factor for reoperation. Moreover, muscle attachment sites (MAS) have to be detached occasionally. To improve current surgical clavicle fracture treatment with plate osteosynthesis, a change in plate design is required. The goal of this study was to design a patient-specific clavicle fracture fixation plate that includes geometrical optimization and stiffness determination. Its biomechanical performance has been compared with a commercial plate by examining the geometric fit, anatomical outline, stresses and interfragmentary motion using a finite element analysis with physiological loading and boundary conditions. Evaluation showed a better geometrical fit of the patient-specific plate as well as an improved fracture reduction. Displacements between fracture fragments were lower in case of the patient-specific plate, both when a fracture gap and no fracture gap were present. Results indicate a superior mechanical performance in terms of all investigated outcomes of the patient-specific plate compared to the commercial plate, while better aligning with the patient-specific geometry and without the need for MAS release. Due to the patient-specific geometry and reduced thickness, these fixation plates are expected to decrease the operation time, as intraoperative contouring will become irrelevant, and to decrease reoperation rates as implant irritation will be minimized.
Original languageEnglish
Pages (from-to)1695-1706
Number of pages12
JournalJournal of Orthopaedic Research
Volume40
Issue number7
DOIs
Publication statusPublished - Jul 2022
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2021 Orthopaedic Research Society. Published by Wiley Periodicals LLC.

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