Biomechanical Comparison of a Novel Implant and Commercial Fixation Devices for AO/OTA 43-C1 Type Distal Tibial Fracture

Shun-Ping Wang,Kun-Jhih Lin,Kang-Ping Lin,Cheng-En Hsu,Cheng-Min Shih,Chao-Ping Chen

doi:10.3390/app11104395

Abstract

This study compares the novel Asia Distal Lateral Tibial Locking Plate mechanical stability to that of the current anterolateral and medial tibial plates based on finite element analysis. Four-part fracture fragment model of the distal tibia was reconstructed using CAD software. A load was applied to simulate the swing phase of gait. The implant stress and the construct stiffness were compared. The results of the anterolateral plate and the medial plate were similar and the displacement values were determined lower than those in the medial plate. In the simulated distal tibia fracture, the Aplus Asia Distal Lateral Tibial Locking Plate and medial distal tibial plate tibia fixations will lead to a stiffer bone-implant construct compared to the anterolateral distal tibial plate. Moreover, the stress in the Aplus Asia Distal Lateral Tibial Locking Plate was lower than those for the medial distal tibial plate and anterolateral bone plates. The Aplus Asia Distal Lateral Tibial Locking Plate has better stabilization and is an anterolateral plate that avoids more soft tissue damage than other bone plates. The Aplus Asia Distal Lateral Tibial Locking Plate could be one of a suitable design in tibia distal fracture fixation.

Highlights

The treatment of distal tibial fractures can be challenging for a surgeon, which has high infection rate, wound healing complications, and post-traumatic arthritis
Previous studies demonstrated the biomechanical advantages of the medial plate; medial plating would cause soft tissue problems ranging from skin irritation to necrosis [3,4]
In the finite element analysis, the maximum von Mises stress on three different bone plates were 144.15 MPa, 181.00 MPa and 228.82 MPa, respectively

Summary

Introduction

The treatment of distal tibial fractures can be challenging for a surgeon, which has high infection rate, wound healing complications, and post-traumatic arthritis. In an effort to preserve the soft tissue and envelope perform the appropriate osseous reconstruction, multiple surgical approaches and fixation strategies have been developed. The anterolateral plating and medial plating were two major options for plate osteosynthesis via a variety of surgical approaches [1,2,3]. Previous studies demonstrated the biomechanical advantages of the medial plate; medial plating would cause soft tissue problems ranging from skin irritation to necrosis [3,4]. The superficial peroneal nerve is better visualized in the anterolateral approach [5]. Despite these advantages, anterolateral plating fixation stability may be inferior to medial plating in the treatment of distal tibial fractures [6,7]

Results

Discussion

Conclusion