Bone Plate System Research Articles

Clinical performance of tibia bone plate system for fixation of tibia fracture

<p class="abstract"><strong>Background: </strong>In this study, we aimed to investigate the performance of the tibia plates system while treating the tibia fracture fixation. The objective of this study was to reduce the post-operative complications of proximal and distal tibia fracture by using indigenously manufactured implants (plates and screws).</p><p class="abstract"><strong>Methods:</strong> In this retrospective study, we studied the results of the tibia plate system in treatment of tibia fracture. A total of 34 consecutive patients were included in this study (24 males, 10 females and average age 48.6 years). Fracture type was classified as per the Muller AO classification of fracture. According to the AO classification, proximal and distal tibia fractures 41-A, 41-B and 41-C was observed with one year follow up period followed by physical exercises after one month of the surgery. The fractures were treated with wise-lock proximal and distal tibia plates.</p><p class="abstract"><strong>Results: </strong>The outcomes of clinical treatment were obtained in our study; no pain (88.2%), mild pain (11.7%) after 1 year follow up. The follow up of patients was taken on 1 month, 6 months and 1 year according to visual analog scale (VAS) score. No implant related problem have been found like loosening, bending and corrosion. X-ray was used to check the union, non-union. Functional outcomes were assessed with VAS.</p><p class="abstract"><strong>Conclusions:</strong> Treatment of tibia fracture with wise-lock proximal and distal tibia plate shows good outcomes with less complications.</p>

Comparison of locking and non-locking reconstruction plate-screw system in lateral mandibular defects by finite element analysis

PurposeThe purpose of this study is to analyze and compare stress distribution on bone screws and plate systems in locking and non-locking screw-plates design in lateral mandibular defects. Material and methodsSolid mathematical model of mandible was created by three-dimensional finite elements analysis and 25 mm length of lateral resection (L defect) was performed on the model. Models were reconstructed with 2.4 locking and non-locking reconstruction plate system. Each masticator muscles attached to mandible were simulated as direction, attachment area and magnitude on 3D model to compare with reality. The stress formation on bone and hardware system were evaluated. ResultThe stress values on the cortical bone, plate and screw system were higher in conventional plate model than the locking system model. The highest stress values were measured in the proximal segment especially in conjunction with conventional screw system. Furthermore, the distribution of stress on the bone surface was more homogenous in the locking system. ConclusionIt is evident that the use of the locking system in 25 mm length lateral mandibular defects provides an additional advantage over conventional systems in reconstruction models.

Adjustable bone plate: state of art

Background/aimThe success of treatment of bone fracture and defects are based on a proper contact and compression between the bone fracture fragments. Intraoperative manipulations such as bone compression or distractions are generally done in order to achieve this. However, none of the bone plates currently in routine use allow these manipulations after fixation to the bone, requiring refixation and repeated drilling, and screwing operations. Based on this shortcoming, we designed a novel adjustable bone plate (ABP) system which allows bone shortening and lengthening even after fixation to the bone surface. The aim of the paper is to clarify the unique properties of the novel bone plate.Materials and methodsIn this paper, the new generation adjustable bone plate applicability, design, indication, and new characteristics in addition to conventional bone plates with review of the literature were discussed and surgical technique was demonstrated in a saw bone model.Results This novel design allows for compression and distraction at the fracture ends post fixation as well as bone segment transfers.ConclusionsThe potential of the new generation ABP plate for use in bone compression, distraction, and the segmental bone transfer is a promising invention for clinical applications in the future.

Biomechanical evaluation of the screw preload values used in the plate placement for bone fractures

The purpose of this study is to examine the effects of screw preload values on the bone-plate system. The preload value was taken differently in the literature range from 50 N to 3000 N. These preload value were examined in this study. The finite element method was used to calculate the strain and stress on the models. The long bone, plate and screws were modeled as 3D using CAD software. The finite element models were created using Ansys Workbench software. The convergence and validation study were made for the correct results. The 400 N axial load was applied to the proximal end of bone. The distal end of the bone fixed for boundary condition. The preload values were applied to the screws differently. The results of the finite element analysis were compared and evaluated. The results showed that when the preload values increased, the von Mises stresses and strains on the bone and plate system increased. The critical preload value of the screw is the 500 N. The upper values of this critical value can be damaged bone and plate system. The critical region of the bone is the holes where the screw inserted. In conclusion, the preload values of the screw should not exceed the 500 N for the successful fixation.

Engineering and Manufacturing of a Dynamizable Fracture Fixation Device System

The present work illustrates the dynamization of an orthopaedic plate for internal fracture fixation which is thought to shorten healing times and enhance the quality of the new formed bone. The dynamization is performed wirelessly thanks to a magnetic coupling. The paper shows the peculiarities of the design and manufacturing of this system: it involves two components, sliding with respect to each other with an uncertain coefficient of friction, and with a specific compounded geometry; there are stringent limits on component size, and on the required activation energy. Finally, the device belongs to medical devices and, as such, it must comply with the respective regulation (EU 2017/745, ASTM F382). The design of the dynamizable fracture fixation plate has required verifying the dynamic of the unlocking mechanism through the development of a parametric multibody model which has allowed us to fix the main design variables. As a second step, the fatigue strength of the device and the static strength of the whole bone-plate system was evaluated by finite element analysis. Both analyses have contributed to defining the final optimized geometry and the constitutive materials of the plate; finally, the respective working process was set up and its performance was tested experimentally on a reference fractured femur. As a result of these tests, the flexural stiffness of the bone-plate system resulted equal to 370 N/mm, while a maximum bending moment equal to 75.3 kN·mm can be withstood without plate failure. On the whole, the performance of this dynamic plate was proved to be equal or superior to those measured for static plates already on the market, with excellent clinical results. At the same time, pre-clinical tests will be an interesting step of the future research, for which more prototypes are now being produced.

Fracture Repair in Cats Using a Conical Coupling Mini 1.9 to 2.5 mm Locking Plate System.

The aim of this study was to retrospectively evaluate the clinical application of the Fixin mini 1.9 to 2.5 system for the treatment of long bone fractures in cats. We proposed that the Fixin mini system would successfully stabilize long bone fractures in cats with a healing time and complication rate similar to those previously reported for feline fractures using other locking bone plate systems. Medical records and radiographs of cats with long bone fractures stabilized with the Fixin mini 1.9 to 2.5 system were retrospectively reviewed. Signalment, body weight, bone(s) fractured, region of bone fractured, fracture classification, concurrent orthopaedic injuries, complications, time to functional union, if minimally invasive plate osteosynthesis techniques were used, plate size, number of plates, bone graft use and ancillary methods of fixation were recorded. Fifty-six fractures in 54 cats were included. Mean time to radiographic union was 8.8 weeks. Complications were recorded in 8 out of 56 fractures. Major complications occurred in 4 of 56 fractures and minor complications occurred in 4 of 56 fractures. The Fixin mini 1.9 to 2.5 system had an overall complication rate and time to functional union similar to that of other implant systems used to treat feline long bone fractures and it appears suitable for repair of a wide variety of long bone fracture configurations in cats.

The Edentulous Atrophic Mandible Fracture: A Case Report Supporting Use of Large Bone Plating Systems and Discussion of the Value of Identifying Patient Treatment Goals

The Edentulous Atrophic Mandible Fracture: A Case Report Supporting Use of Large Bone Plating Systems and Discussion of the Value of Identifying Patient Treatment Goals

Biomechanical analysis of a bone-plate system to treat forearm fractures

The degeneration of the human body due to the passage of time in conjunction with the increase in life expectancy have led to the evolution in the treatment of fractures In Mexico traffic accidents and falls account for a risk of muscle injury especially fractures in patients aged to years and are the leading cause of medical disabilities Radius ulna fractures rank second in patients between the ages of and this frequency makes the treatment of these fractures paramount to the health system Currently the treatment of radio fractures is done using stents such as bone plates as these offer greater mechanical support compared to the old methods plasters bandages and tablets providing a correct stability and improvement in the healing of bone tissue The internal fixation device modeled in this work for the treatment of radio fractures is a plate made of L steel medical grade which thanks to its mechanical properties and biocompatibility with the human body ensure a bone remodeling reducing the risk of possible infections and or malformations in patients

Static and dynamic analyses of fracture fixation bone-plate systems for different plate materials and dimensions.

Various techniques have been developed in the treatment of fractures. One of these techniques is the internal fixation, which has an important place in practice. In this study, fractured tibia bone has been treated with implants as numerically to investigate the stress behavior and the effect of plate material, shape and dimensions under pressure load. The outer part of the bone is chosen as orthotropic and the inner part is chosen as isotropic material. The plate has been modeled to take the form of the bone surface and the finite element method has been used for numerical analysis. The effect of stress on bones and implants has been examined for 1% healing by changing the plate length, plate width and plate material. It has been observed that the increase in plate length decreases cortical bone stress until a specific length. On the other hand, the increase in plate width has increased the stress on the bone. It is important to form the appropriate plate surface to the bone surface in terms of compliance with the bones.

Finite element analysis of functionally graded bone plate at femur bone fracture site

This paper focuses on the analysis of fractured Femur bone with functionally graded bone plate. The Femur bone is modeled by using the data from the CT (Computerized Tomography) scan and the material properties are assigned using Mimics software. The fracture fixation plate used here is composed of Functionally Graded Material (FGM). The functionally graded bone plate is considered to be composed of different layers of homogeneous materials. Finite element method approach is adopted for analysis. The volume fraction of the material is calculated by considering its variation along the thickness direction (z) according to a power law and the effective properties of the homogeneous layers are estimated. The model developed is validated by comparing numerical results available in the literature. Static analysis has been performed for the bone plate system by considering both axial compressive load and torsional load. The investigation shows that by introducing FG bone plate instead of titanium, the stress at the fracture site increases by 63 percentage and the deformation decreases by 15 percentage, especially when torsional load is taken into consideration. The present model yields better results in comparison with the commercially available bone plates.

Inherent Strength of the osteo-WEDGE™ Bone Plate Locking System for Arthrodesis of the First Metatarsocuneiform Joint: A Biomechanical Study

First metatarsocuneiform joint arthrodesis with a locking bone plate and screw system has been effectively used to correct metatarsus primus varus and instability of the first ray. The goal of the present cadaveric biomechanical study was to quantify and compare the inherent strength of the first metatarsocuneiform joint and surrounding bones fixated with the osteo-WEDGE™ bone plate locking system (OW) with that of intact specimens. Fourteen fresh-frozen adult human cadaveric foot specimens consisting of the first metatarsal and medial cuneiform bones with intact joint capsules and ligaments were used. The OW was implanted in 7 of these specimens at the first metatarsal cuneiform joint (MCJ), and the remaining 7 specimens were left intact. Each of the specimens was then subjected to axial force to simulate dorsiflexion of the first metatarsal using a cantilever bending test setup. Load was applied on the plantar aspect of the first metatarsal head until failure of the construct. The mean load and bending moment on the first MCJ at failure for the implanted specimens were 119.98 ± 56.76 N and 5.57 ± 2.71 Nm, respectively. For the intact specimens, the mean load and bending moment on the first MCJ at failure were 107.93 ± 60.90 N and 6.07 ± 3.18 Nm, respectively. None of the specimens showed catastrophic failure within the physiologic loading limits. These results imply that the mechanical strength of the OW is comparable to that of intact specimens. Thus, the first MCJ and surrounding bones fixated with an OW should be able to effectively withstand the vertical ground reaction forces the same as intact specimens.

A comparitive study of interflex plates versus standard conventional miniplates for rigid fixation of mandibular symphysis/body fractures

Background and objectives: The objective of this study was to evaluate outcomes for 2 bone plating systems used in the treatment of mandibular symphysis/body fractures.

Evaluation of locking and non-locking reconstruction plate–screw system with lateral mandibular defects by FEA

Objectives: The purpose of this study is to analyse and compare stess distrubiton on bone screws and plate systems in locking and non-locking screw–plates design with two different size of lateral mandibular defects.

유한요소법을 이용한 골절치료용 임플란트 시스템 형상설계에 관한 연구

This paper investigates shape design processes of two implant systems for bone fracture treatment ; Bone plate and Interlocking nail system. These systems can directly fix fractured human bones by surgical operations. The bone plates consist of various shaped plates and implant screws for fixation of fractured human bones with various manual instruments allowing to handle them. The material corresponds to titanium alloy Ti6Al4V because it is harmless material for human body as well as significantly rigid. This system has to be suitably rigid as well as manually bended in orthopedic surgery operations. The Interlocking nail system is a kind of nail implanted inside fractured human bones. The shapes of these systems have to be suitably designed in order to endure various loads as well as avoid any damages. If various shaped prototypes would be fabricated and tested to design the optimal shapes, optimal shapes could be obtained but very long time and expensive costs must be required. In this paper finite element method was applied into these systems. Under various boundary conditions a series of structural analysis was conducted by using ANSYS. Finally important shape factors could be determined on the basis of the analysis results.

THREE DIMENSIONAL BONE PLATING SYSTEM IN THE MANAGEMENT OF MANDIBULAR FRACTURES-A CLINICAL STUDY

Over the past many years, various bone plating systems have been developed to provide stable fixation for the mandible fractures were proposed and performed. The aim of the study was to evaluate efficacy of three dimensional (3-D)titanium mini plates in the management of mandibular fractures, and to analyze structural stability of the fractured bone fragments after fixation, to evaluate the biocompatibility of the three dimensional plating system and the morbidity of three dimensional plating system. Patients and Methods: 20 patients with mandibular fractures required open reduction internal fixation of the fractures using three dimensional mini plate osteosynthesis over a period of 2 yrs. prospectively. Conclusions: Three dimensional titanium miniplates provide good stabilization of fractured fragments in three dimensions due to closed quadrangular geometric shape and ease of contouring and adapting. Less surgical exposure of underlying fracture site is needed, with a minimal traction of the surrounding soft tissue. They are biocompatible and no morbidity seen in our study.

Optimal Design of Bone Plate System Using Finite Element Method

This paper investigates a design optimization for "Bone Plate System" which can directly fix human bones fractured. The active trauma system consists of several shaped bone plates and implant screws for fixation of fractured human bones with various manual instruments allowing to handle them. The material corresponds to titanium because it was well known as harmless material when being inserted into human body. This system has to be suitably rigid as well as manually bended in orthopedic surgery operations. Then bone plates have to be designed with suitable shapes. In order to verify whether bone plates were well designed, a series of bending tests. However optimized shapes of bone plates have to be determined before unnecessary a number of bending tests. For this purpose FEM(Finite Elements Method) was applied during design process which allows us to investigate the bending strengths of bone plates. Based on FEM results, dimensions of bone plates were optimized in order to be suitably rigid without actual bending tests.

Impact Response and Simulation of Damaged Ulna With Internal Fixation

The objectives of this work were to explore a methodology that combines static and dynamic finite element (FE) analysis, linear elastic fracture mechanics (LEFM) and experimental methods to investigate a worst-case scenario in which a previously damaged bone plate system is subjected to an impact load. Cadaver ulnas with and without midshaft dynamic compression plates are subjected to a static three-point bend test and loaded such that subcritical crack growth occurs as predicted by a hybrid method that couples LEFM and static FE. The plated and unplated bones are then unloaded and subsequently subjected to a midshaft transverse impact test. A dynamic strain-based FE model is also developed to model the midshaft transverse impact test. The average value of the impact energy required for failure was observed to be 10.53% greater for the plated set. There appears to be a trade-off between impact damage and impact resistance when ulnas are supported by fixation devices. Predictions from the dynamic FE model are shown to corroborate inferences from the experimental approach.

Efficacy of 2-mm locking miniplates in the management of mandibular fractures without maxillomandibular fixation

Background:The management of trauma has evolved greatly over the past many years. Various bone plating systems have been developed to provide stable fixation of mandibular fractures. The introduction of the locking plate/screw system has offered certain advantages over the conventional plating systems. This system does not require intimate adaptation of the miniplates to the underlying bone and has greater stability. This study evaluates the efficacy of locking miniplate/screw system in the treatment of mandibular fractures without maxillomandibular fixation.Materials and Methods:This was a prospective study analyzing 20 patients with undisplaced or minimally displaced mandibular fractures, who reported to Department of Oral and Maxillofacial Surgery, Government Dental College and Research Institute, Bangalore. The selected cases were treated by open reduction and internal fixation using the 2.0 mm locking plate/screw system.Results:Open reduction and internal fixation with the 2.0 mm locking plate/screw system were achieved in all the 20 cases with satisfactory stability of the fracture fragments. The system was found to be reliable and effective intraoperatively. Only two complications were noted in the study.Conclusion:The locking miniplate system was found to be reliable and effective in management of mandibular fractures without postoperative intermaxillary fixation, however further studies with more sample size is required.

Assessment of function-graded materials as fracture fixation bone-plates under combined loading conditions using finite element modelling

In previous work by Fouad (Medical Engineering and Physics 2010 [23]), 3D finite element (FE) models for fractured bones with function-graded (FG) bone-plates and traditional bone-plates made of stainless steel (SS) and titanium (Ti) alloy were examined under compressive loading conditions using the ABAQUS Code. In this study, the effects of the presence of the torsional load in addition to the compressive load on the predicted stresses of the fracture fixation bone-plate system are examined at different healing stages. The effects on the stress on the fracture site when using contacted and non-contacted bone-plate systems are also studied. The FE modelling results indicate that the torsional load has significant effects on the resultant stress on the fracture fixation bone-plate system, which should be taken into consideration during the design and the analysis. The results also show that the stress shielding at the fracture site decreases significantly when using FG bone-plates compared to Ti alloy or SS bone-plates. The presence of a gap between the bone and the plate results in a remarkable reduction in bone stress shielding at the fracture site. Therefore, the significant effects of using an FG bone-plate with a gap and the presence of torsional load on the resultant stress on the fracture fixation bone-plate system should be taken into consideration.

Effects of the bone-plate material and the presence of a gap between the fractured bone and plate on the predicted stresses at the fractured bone

In the present study, 3D finite element models for fractured bones with function-graded (FG) bone-plates and traditional bone-plates made of stainless steel (SS) or titanium (Ti) alloy are generated using the ABAOUS code. The predicted Von Mises stresses at the fracture site and underlying bone-plate are examined at different healing stages. The effects on the predicted Von Mises stresses at the fracture site of the presence of a gap between the plate and fractured bone are also studied. Based on the analytical results, it is found that the stress shielding at the fracture site at the fully healed stages decreases when using FG bone-plates compared to Ti alloy or SS bone-plates. In the initial healing stages, the Von Mises stresses at the fracture site increase (stress shielding decreases) by 17% and 11% when using FG bone-plates as compared to SS bone-plates for contacted and non-contacted bone-plate system, respectively. The significant effects of using an FG bone-plate with a gap on the resultant Von Mises stresses on the bone underneath the plate and on the bone stress shielding should be taken into consideration during fractured bone fixation.