Finite element analysis of dual small plate fixation and single plate fixation for treatment of midshaft clavicle fractures

• Published in: Journal of orthopaedic surgery and research Vol. 15; no. 1; p. 148
• Main Authors: Zhang, Fangxue, Chen, Fancheng, Qi, Yuhan, Qian, Zhi, Ni, Shuo, Zhong, Zeyuan, Zhang, Xu, Li, Dejian, Yu, Baoqing
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 15.04.2020; BioMed Central; BMC
• Subjects: Bending stresses; Biomechanical Phenomena - physiology; Biomechanics; Bone Plates; Care and treatment; Clavicle; Clavicle - diagnostic imaging; Clavicle - injuries; Clavicle - surgery; Clavicle fracture; Compression; Dual small plating; Finite Element Analysis; Finite element method; Fracture Fixation, Internal - methods; Fractures; Fractures (Injuries); Fractures, Bone - diagnostic imaging; Fractures, Bone - surgery; Humans; Imaging, Three-Dimensional - methods; Internal fixation; Larger single plate constructs; Male; Mechanical properties; Middle Aged; Orthopedics; Software; Sports injuries; Studies; Titanium; Transplants & implants; Treatment Outcome; United States > US; Biomechanics; Larger single plate constructs; Finite element analysis; Dual small plating; Clavicle fracture
• ISSN: 1749-799X; 1749-799X
• DOI: 10.1186/s13018-020-01666-x

Midshaft clavicle fractures are one of the most familiar fractures. And, dual small plate fixation has been reported as can minimize hardware-related complications. However, the biomechanical properties of the dual small plate fixation have not yet been thoroughly evaluated. Here, we report the results of a finite element analysis of the biomechanical properties of midshaft clavicle fractures treated with dual small plating and superior and anteroinferior single plate fixation. A three-dimensional (3D) finite element model of the midshaft clavicle fractures was created, whose 4-mm transverse fracture gap, having an angle < 30 degree and devoid of overlapping triangles, was simulated between the fractured segments of the middle-shaft of the clavicle. The equivalent von Mises stress and displacement of the model was used as the output measures for analysis. No significant differences were found between dual plating, superior or anteroinferior single plating in cantilever bending, axial compression, and axial torsion. Dual plating with a smaller plate-screw construct is biomechanically eligible to compare with superior and anteroinferior single plate fixation using larger plate-screw constructs. This study demonstrated that larger plate-screw constructs for the treatment of simple are placed clavicular fractures; however, weight-bearing and exorbitant shoulder activity should be avoided after the operation. Therefore, dual plating may provide a viable option for fixing midshaft clavicle fractures and, thus, may be preferred for patients who need early activity.