Abstract
The treatment of fractures of the distal tibia can be problematic due to the insubstantial soft-tissue covering this part of the anatomy. This study investigates a novel strategy for minimally invasive plate osteosynthesis of distal tibia fractures called bionic lightweight design plating. Following the structure of the animal trabecular bone, we utilized topological mathematical methods to redesign the material layout of the internal fixation device to fulfill the desired lightweight design within given boundary conditions. The results showed that this method can maintain the same stability of the construct as the original plate after a reduction in the original volume by 30%, and the differences in strain energy of plates and maximum node displacement of constructs between the constructs [RP construct vs. LP construct] were not statistically significant (p > 0.05). In the safety assessment of the constructs, the peak stress of plates between constructs was found to not be statistically significantly different under a doubled physiological load (p > 0.05). The average stress of the plates’ elements exceeding the allowable stress was analyzed, and no statistically significant differences were found between the two constructs under axial compression stress conditions (p > 0.05). The average stress of the plates’ elements in the redesigned plating construct under torsional stress conditions was 3.08% less than that of the locked plating construct (p < 0.05). Under the double physiological load condition, 89% of the elements of the plate in the redesigned plating construct and 85% of the elements of the plate in the locked plating construct were lower than the maximum safe stress of the plate, which was 410 MPa (secondary allowable stresses). That reminds us the topology optimization offer a possible way to improve the capacity of soft tissue protection while ensuring the safety of the RP construct by reducing the volume of the implants.
Highlights
The incidence of distal tibia fracture is high, and it is one of the most common long bone fractures (Court-Brown and McBirnie, 1995; Weiss et al, 2009; Vaienti et al, 2019)
This method can reduce the strain of the tension direction ε and that in the vertical direction ε# of the soft tissue, which in theory causes decreased stress acting on the blood vessels in soft tissue
As the effect on the vascular diameter decreases, the effects on blood flow velocity, flow rate, and strain on the vascular elements caused by these changes in hemodynamics decreases (Liu et al, 2001; Berman et al, 2020)
Summary
The incidence of distal tibia fracture is high, and it is one of the most common long bone fractures (Court-Brown and McBirnie, 1995; Weiss et al, 2009; Vaienti et al, 2019) Such fractures usually lead to the stripping of the periostea, poor soft-tissue blood supply, and severe trauma to the surrounding soft tissue structures because of its relative thinness. In cases of unhealthy soft tissue at the anterior tibia, ORIF surgery on the tibia distal segment can cause increased rates of nonunion, deep infections (Sirkin et al, 2004), and surgical wound dehiscence (Teeny and Wiss, 1993; Sheerin et al, 2006; Vidović et al, 2015) This is true even in a staged approach, which is considered to be an effective way of handling soft tissues (Sheerin et al, 2006; Chan et al, 2017) for distal tibia fractures through temporized treatment. We hypothesized that bionic lightweight design optimization plates will reduce the compression of the implant on the soft tissue by reducing the implant volume while retaining construct strength relative to standard locking plates
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
