J Shanghai Jiaotong Univ Sci

Journal of Shanghai Jiaotong University(Science) >

2021 , Vol. 26 >Issue 3: 259 - 266

DOI: https://doi.org/10.1007/s12204-021-2291-7

Medical 3D Printing and Personalised Medicine

Biomechanical Analysis of Personalised 3D-Printed Clavicle Plates of Different Materials to Treat Midshaft Clavicle Fractures

Expand
  • (1. School of Biomedical Engineering & Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200030,
    China; 2. Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University
    School of Medicine, Shanghai 200011, China; 3. Department of Orthopedics, B¨urgerspital Solothurn,
    Sch¨ongr¨unstrasse 42, CH-4500 Solothurn, Switzerland)

Online published: 2021-06-02

Supported by

the National Natural Science Foundation
of China (Nos. 81772425, 31771017, and 31972924),
the Project of Science and Technology Commission
of Shanghai Municipality (No. 16441908700), the Innovation
Research Plan of Shanghai Municipal Education
Commission (No. ZXWF082101), the National
Key Research and Development Program of
China (Nos. 2017YFC0110700, and 2019YFC0120600),
and the Interdisciplinary Program of Shanghai Jiao
Tong University (Nos. YG2016MS11, JYYQ201516,
YG2017MS09, and ZH2018QNA06)

Fold

Abstract

This study was aimed at comparing the biomechanical performance of personalised 3D-printed clavicle  plates of different materials to treat midshaft clavicle fractures with the finite element (FE) method. The FE  model of a fractured clavicle with a personalised 3D-printed clavicle plate and screws was constructed. Three  types of materials were simulated, including stainless steel, titanium alloy, and magnesium alloy. Two loading  conditions (axial compression and inferior bending) were applied at the distal end of the clavicle to simulate arm  abduction. Plate stiffness, peak stress, and bone strain at the clavicle fracture site were measured and compared.  The stiffness of the stainless steel clavicle plate was significantly greater than that of the titanium alloy clavicle  plate. The stiffness of the magnesium alloy clavicle plate was similar to that of the intact clavicle; peak stress  of the magnesium alloy clavicle plate was the lowest; thus, it had less stress-shielding effects on bone formation.  The magnesium alloy clavicle plate was more likely to form bone by distributing proper strain at the clavicle  fracture site. According to the influence of different materials on the tensile strength, magnesium alloy clavicle  plates might be preferred owing to their bionic stiffness in the treatment of patients with a low risk of falling. For  patients who engage in contact sports, a titanium alloy clavicle plate might be more suitable.

Cite this article

CHENG Rongshan, (程荣山), JIANG Ziang, (蒋子昂), DIMITRIOU Dimitris, GONG Weihua, (龚伟华), TSAI Tsung-Yuan, (蔡宗远) . Biomechanical Analysis of Personalised 3D-Printed Clavicle Plates of Different Materials to Treat Midshaft Clavicle Fractures[J]. Journal of Shanghai Jiaotong University(Science), 2021 , 26(3) : 259 -266 . DOI: 10.1007/s12204-021-2291-7

References

 [1] KHAN L A K, BRADNOCK T J, SCOTT C, et al. Fractures of the clavicle [J]. The Journal of Bone and Joint Surgery -American Volume, 2009, 91(2): 447- 460. 
[2] NOWAK J, MALLMIN H, LARSSON S. The aetiology and epidemiology of clavicular fractures: A prospective study during a two-year period in Uppsala, Sweden [J]. Injury, 2000, 31(5): 353-358. 
[3] VANDER HAVE K L, PERDUE A M, CAIRD M S, et al. Operative versus nonoperative treatment of midshaft clavicle fractures in adolescents [J]. Journal of Pediatric Orthopedics, 2010, 30(4): 307-312.
[4] Canadian Orthopaedic Trauma Society. Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures [J]. The Journal of Bone & Joint Surgery, 2007, 89(1): 1-10.
[5] KULSHRESTHA V, ROY T, AUDIGE L. Operative versus nonoperative management of displaced midshaft clavicle fractures: A prospective cohort study [J]. Journal of Orthopaedic Trauma, 2011, 25(1): 31-38. 
[6] MIRZATOLOOEI F. Comparison between operative and nonoperative treatment methods in the management of comminuted fractures of the clavicle [J]. Acta Orthopaedica et Traumatologica Turcica, 2011, 45(1): 34-40. 
[7] NI M, NIU W X, WONG D W C, et al. Finite element analysis of locking plate and two types of intramedullary nails for treating mid-shaft clavicle fractures [J]. Injury, 2016, 47(8): 1618-1623. 
[8] ZLOWODZKI M, ZELLE B A, COLE P A, et al. Treatment of acute midshaft clavicle fractures: Systematic review of 2 144 fractures: On behalf of the Evidence-Based Orthopaedic Trauma Working Group [J]. Journal of Orthopaedic Trauma, 2005, 19(7): 504- 507. 
[9] PENGRUNG N, LAKDEE N, PUNCREOBUTR C, et al. Finite element analysis comparison between superior clavicle locking plate with and without screw holes above fracture zone in midshaft clavicular fracture [J]. BMC Musculoskeletal Disorders, 2019, 20(1): 465. 
[10] NIINOMI M, NAKAI M. Titanium-based biomaterials for preventing stress shielding between implant devices and bone [J]. International Journal of Biomaterials, 2011, 2011: 836587. 
[11] GARDNER M J, EVANS J M, DUNBAR R P. Failure of fracture plate fixation [J]. The Journal of the American Academy of Orthopaedic Surgeons, 2009, 17(10): 647-657. 
[12] LAU T W, LEUNG F, CHAN C F, et al. Wound complication of minimally invasive plate osteosynthesis in distal tibia fractures [J]. International Orthopaedics, 2007, 32(5): 697-703. [13] HAASE K, ROUHI G. A discussion on plating factors that affect stress shielding using finite element analysis [J]. Journal of Biomechanical Science and Engineering, 2010, 5(2): 129-141. 
[14] LI J L, QIN L, YANG K, et al. Materials evolution of bone plates for internal fixation of bone fractures: A review [J]. Journal of Materials Science & Technology, 2020, 36: 190-208. [15] STAIGER M P, PIETAK A M, HUADMAI J, et al. Magnesium and its alloys as orthopedic biomaterials: A review [J]. Biomaterials, 2006, 27(9): 1728-1734. 
[16] FANG R X, JI A M, ZHAO Z H, et al. A regression orthogonal biomechanical analysis of internal fixation for femoral shaft fracture [J]. Biocybernetics and Biomedical Engineering, 2020, 40(3): 1277-1290. 
[17] LIU P C, YANG Y J, LIU R, et al. A study on the mechanical characteristics of the EBM-printed Ti-6Al-4V LCP plates in vitro [J]. Journal of Orthopaedic Surgery and Research, 2014, 9(1): 106. 
[18] ZENG L Q, WEI H F, LIU Y J, et al. Titanium elastic nail (TEN) versus reconstruction plate repair of midshaft clavicular fractures: A finite element study [J]. PLoS One, 2015, 10(5): e0126131. 
[19] ˇSEˇSOK A, VAITIEK¯UNAS M. Modelling of bone fixation plate from biodegradable magnesium alloy [J]. Mokslas - Lietuvos Ateitis/Science -Future of Lithuania, 2019, 11: mla.2019.7092 
[20] FAVRE P, KLOEN P, HELFET D L, et al. Superior versus anteroinferior plating of the clavicle: A finite element study [J]. Journal of Orthopaedic Trauma, 2011, 25(11): 661-665. [21] RHO J Y, HOBATHO M C, ASHMAN R B. Relations of mechanical properties to density and CT numbers in human bone [J]. Medical Engineering & Physics, 1995, 17(5): 347-355. [22] DROSDOWECH D S, MANWELL S E, FERREIRA L M, et al. Biomechanical analysis of fixation of middle third fractures of the clavicle [J]. Journal of Orthopaedic Trauma, 2011, 25(1): 39-43. 
[23] CRONSK¨AR M, RASMUSSEN J, TINNSTEN M. Combined finite element and multibody musculoskeletal investigation of a fractured clavicle with reconstruction plate [J]. Computer Methods in Biomechanics and Biomedical Engineering, 2015, 18(7): 740-748. 
[24] TOKSVIG-LARSEN S, RYD L. Surface characteristics following tibial preparation during total knee arthroplasty [J]. The Journal of Arthroplasty, 1994, 9(1): 63-66. 
[25] CHIU Y C, HUANG K C, SHIH C M, et al. Comparison of implant failure rates of different plates for midshaft clavicular fractures based on fracture classifications [J]. Journal of Orthopaedic Surgery and Research, 2019, 14(1): 220. 
[26] ZHANG X J, CHENG X D, YIN B, et al. Finite element analysis of spiral plate and Herbert screw fixation for treatment of midshaft clavicle fractures [J]. Medicine, 2019, 98(34): e16898. [27] WILSON D J, WEAVER D L, BALOG T P, et al. Early postoperative failure of a new intramedullary fixation device for midshaft clavicle fractures [J]. Orthopedics, 2013, 36(11): e1450-e1453. 
[28] CHEN J H, LIU C, YOU L D, et al. Boning up on Wolff’s Law: Mechanical regulation of the cells that make and maintain bone [J]. Journal of Biomechanics, 2010, 43(1): 108-118. 
[29] WU Z Y, LIU Y P, SINGARE S, et al. Animal model for evaluation of strain gauge in mandibular distraction osteogenesis in rabbits [J]. British Journal of Oral and Maxillofacial Surgery, 2007, 45(8): 633-636. 
[30] ZHANG F X, CHEN F C, QI Y H, et al. Finite element analysis of dual small plate fixation and single plate fixation for treatment of midshaft clavicle fractures [J]. Journal of Orthopaedic Surgery and Research, 2020, 15(1): 148. 


Options
Outlines

/

〈 〉