Bone Plate Design Research Articles

Convolutional neural network for assisting accuracy of personalized clavicle bone implant designs

<span lang="EN-US">The clavicle is a long bone that tends to be frequently fractured in the midshaft region. The plate and screw fixing method is mainly applied to address this issue. This study aims to construct a clavicle bone implant design with a consideration to achieve a high accuracy and high-quality surface between the plate and the clavicle surface. The computational tomography scanning (CT-scan) image series data were processed using a convolutional neural network (CNN) to classify the clavicle image. The CNN outcomes were gathered as three-dimensional (3D) volume data of clavicle bone. This 3D model was then proposed for the plate design. The CNN testing results of 97.4% for the image clavicle bones classification, whereas the prints of the 3D model from clavicle bone and its plate and screw design reveal compatibility between the bone surface and the plate surface. Overall, the CNN application to the series of CT images could ease the classification of clavicle bone images that would precisely construct the 3D model of clavicle bone and its suitable clavicle bone plate design. This study could contribute as a guideline for other bone plate areas that need to fit the patient’s bone geometry.</span>

Cylindrical depth image based customized helical bone plate design

Commercial straight metal plates have been generally used to fix fractured bones, but recently, the need for customized and helical metal plates has emerged. Customized metal plates are designed to fit the shape of the fracture area that is a 3D curved surface, making it more difficult than designing on a 2D plane. Helical plates are researched due to their advantage in avoiding blood vessel damage compared to commercially available straight metal plates. In this paper, we propose a novel algorithm to design a customized helical metal plate for the femur using cylindrical depth images and Boolean operations. We also present the results of 3D printing a metal plate designed using the proposed algorithm, and the shape matching is verified by calculating the minimum distance between the surface of the printed plate and the surface of the femur.

A metamaterial bone plate for biofixation based on 3D printing technology

Bone plate design and production methods are critical for producing metamaterial bone plates. This study investigated the design and development process of porous structures and metamaterial bone plates for biofixation applications. We designed the porous structures for bone plates using parametric modeling and fused them via the implicit surface fusion method. Likewise, we designed the metamaterial bone plate structure using reverse reconstruction and topological optimization. Thereafter, we utilized three-dimensional (3D) printing for producing and post-processing the metamaterial bone plate. We observed a reduced stress-shielding effect after topological optimization. Additionally, the resultant diamond porous structure maintained a high porosity under pressure. The 3D-printed bone plates and fillers had a bright porous surface, with clear pore structures and good connectivity. The assembly of the 3D-printed femur, bone plate, filler, and standardized screw indicated a good fitting, and the filler could be fixed by the inclined surface. Taken together, the findings of this study established the foundation for the prospective application of metamaterial bone plates in biofixation.

Optimizing Orthopaedic Bone Plates for Directed Energy Deposition with Generative Design and Topological Optimization Approaches

Directed Energy Deposition (DED), a metal additive manufacturing technique, shows promise for future orthopaedic applications, especially in bone plate manufacturing. The need for patient-specific solutions in orthopaedics is growing, driven by the limitations of traditional bone plates made from stainless steel or titanium alloys and the rising incidence of complex fractures. This paper explores the design of orthopaedic bone plates using Generative Design (GD) and Topological Optimization (TO), aimed at eventual production through DED. By focusing on design, the research addresses challenges like stress shielding, caused by the modulus disparity between conventional plate materials and natural bone. Significant findings include mass reductions of 43.7% and 44.2% for GD designs GD1 and GD2, respectively, and a 36% reduction for the TO design TO1, enhancing biomechanical performance with improved strain values. The findings demonstrate GD’s effectiveness in generating anatomically congruent implants, showcasing advancements in personalized care and fracture treatment. The integration of GD and DED within the Design for Additive Manufacturing (DfAM) framework offers a promising pathway for future research focused on refining patient-specific designs and manufacturing processes, aligning with the evolving needs of orthopaedic treatments.

3D printed patient-specific fixation plates for the treatment of slipped capital femoral epiphysis: Topology optimization vs. conventional design

Orthopedic plates are commonly used after osteotomies for temporary fixation of bones. Patient-specific plates have recently emerged as a promising fixation device. However, it is unclear how various strategies used for the design of such plates perform in comparison with each other. Here, we compare the biomechanical performance of 3D printed patient-specific bone plates designed using conventional computer-aided design (CAD) techniques with those designed with the help of topology optimization (TO) algorithms, focusing on cases involving slipped capital femoral epiphysis (SCFE). We established a biomechanical testing protocol to experimentally assess the performance of the designed plates while measuring the full-field strain using digital image correlation. We also created an experimentally validated finite element model to analyze the performance of the plates under physiologically relevant loading conditions. The results indicated that the TO construct exhibited higher ultimate load and biomechanical performance as compared to the CAD construct, suggesting that TO is a viable approach for the design of such patient-specific bone plates. The TO plate also distributed stress more evenly over the screws, likely resulting in more durable constructs and improved anatomical conformity while reducing the risk of screw and plate failure during cyclic loading. Although differences existed between finite element analysis and experimental testing, this study demonstrated that finite element modelling can be used as a reliable method for evaluating and optimizing plates for SCFE patients. In addition to enhancing the mechanical performance of patient-specific fixation plates, the utilization of TO in plate design may also improve the surgical outcome and decrease the recovery time by reducing the plate and incision sizes.

Development and Finite Element Analysis of a Novel Bent Bone Plate

The main purpose of this paper is to develop a new bone plate implant design with middle bending. The bone plate design is carried out using CAD software and then tested using FEA, where output data are combined and analyzed. The simulation outcome from COMSOL Multiphysics shows that all bone plates experienced various degrees of deformation. The best bone plate would be the newly developed plate with a 10° bending angle in the middle, in comparison with the traditional flat rectangular plate, newly flat developed plate, and other bent plate with various bending angles from material or different simulation modelling. The newly developed plate bent with a 10° bending angle in the middle has an average total displacement of 4.61 nm, average von Mises stress of 0.271 MPa, and average first principal strain of 1.77 × 10−6, making it the best choice for clinical application compared with the other bone plates analyzed.

Finite element analysis of biodegradable Ti/polyglycolic acid composite bone plates based on 3D printing concept

Dense metallic bone plates often cause stress shielding, delayed healing, or bone non-unions. Therefore, three-dimensional models of partially biodegradable titanium/polyglycolic acid (Ti/PGA) composite cubes with strut thicknesses of 0.33–1.25 mm were designed to achieve different mechanical properties, and compressive simulations of these models were performed to construct stress–strain plots. Finite element models of these plates were assembled with tibial bone fractures using six bicortical screws. Callus volumes were predicted using a rejection coefficient algorithm, and a mechanoregulation algorithm based on deviatoric strain and fluid flow was employed to simulate the healing process. The effective Young’s moduli were 12.13–84.6 GPa during the first week and 4.4–80 GPa during the sixth week, while the callus volume increased after reducing the Young’s modulus of the bone plate. Thus, the additively manufactured design of biodegradable bone plates can be controlled to achieve the appropriate initial Young’s modulus and degradation rate.

Bone morphological feature extraction for customized bone plate design

Fractures are difficult to treat because of individual differences in bone morphology and fracture types. Compared to serialized bone plates, the use of customized plates significantly improves the fracture healing process. However, designing custom plates often requires the extraction of skeletal morphology, which is a complex and time-consuming procedure. This study proposes a method for extracting bone morphological features to facilitate customized plate designs. The customized plate design involves three major steps: extracting the morphological features of the bone, representing the undersurface features of the plate, and constructing the customized plate. Among these steps, constructing the undersurface feature involves integrating a group of bone features with different anatomical morphologies into a semantic feature parameter set of the plate feature. The undersurface feature encapsulates the plate and bone features into a highly cohesive generic feature and then establishes an internal correlation between the plate and bone features. Using the femoral plate as an example, we further examined the validity and feasibility of the proposed method. The experimental results demonstrate that the proposed method improves the convenience of redesign through the intuitive editing of semantic parameters. In addition, the proposed method significantly improves the design efficiency and reduces the required design time.

Time-dependent in silico modelling of orthognathic surgery to support the design of biodegradable bone plates

Orthognathic surgery is performed to realign the jaws of a patient through several osteotomies. The state-of-the-art bone plates used to maintain the bone fragments in place are made of titanium. The presence of these non-degradable plates can have unwanted side effects on the long term (e.g. higher infection risk) if they are not removed. Using a biodegradable material such as magnesium may be a possible solution to this problem. However, biodegradation leads to a decrease of mechanical strength, therefore a time-dependent computational approach can help to evaluate the performance of such plates. In the present work, a computational framework has been developed to include biodegradation and bone healing algorithms in a finite element model. It includes bone plates and the mandible, which are submitted to masticatory loads during the early healing period (two months following the surgery). Two different bone plate designs with different stiffnesses have been tested. The stiff design exhibited good mechanical stability, with maximum Von Mises stress being less than 40% of the yield strength throughout the simulation. The flexible design shows high stresses when the bone healing has not started in the fracture gaps, indicating possible failure of the plate. However, this design leads to a higher bone healing quality after two months, as more cartilage is formed due to higher strains exerted in fracture gaps. We therefore conclude that in silico modelling can support tuning of the design parameters to ensure mechanical stability and while promoting bone healing.

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.

A new design of 3D-printed orthopedic bone plates with auxetic structures to mitigate stress shielding and improve intra-operative bending

Orthopedic bone plates are most commonly used for bone fracture fixation for more than 100 years. The bone plate design had evolved over time overcoming many challenges such as insufficient strength and excessive plate–bone contact affecting the blood circulation. However, it is only made of two materials, either stainless steel (AISI 316L) or titanium (Ti–6Al–4V). There are two main limitations of metallic bone implants, namely stress shielding and the problem of malocclusion caused by the displacement of the fracture site during healing. To overcome the two problems, a new bone plate design with the incorporation of auxetic structures is proposed in this work. This study aims to use auxetic structure section in the bone plate that would decrease the stiffness of the region, thereby mitigating the stress-shielding effect and at the same time act as a deformable section to enable intra-operative bending for effective alignment while having enough bending strength and stiffness. Two different auxetic structures namely re-entrant honeycomb and missing rib structures were considered. The auxetic structure incorporated bone plates were designed, finite element analysis was done, fabricated using direct metal laser sintering technique, and tested. The results indicate that the re-entrant honeycomb structure incorporated bone plates serve as an effective bone design compared to the conventional bone plate design, in terms of stress shielding and intra-operative bending while offering similar mechanical and bending strength.

Biomechanical investigation of a novel hybrid dorsal double plating for distal radius fractures by integrating topology optimization and finite element analysis

BackgroundCurrently available dorsal locking plates for the treatment of distal radius fractures are far less then volar locking plates, and there is limited evidence about biomechanical strength of dorsal plates. The aim of this study is to develop a novel hybrid dorsal double plating, which enhance biomechanical strength in the articular fixation region and achieve the minimally invasive surgical technique requirement of distal radius fracture treatment by combining weighted topology optimization and finite element (FE) analysis MethodsA dorsal template bone plate design (based on dorsal double plating (DDP)) was constructed to perform weighted topology optimization and FE analysis under six fracture models with 50%, 30%, and 20% weighting of the joint subjected to axial, bending, and torsion moments, respectively. A novel hybrid dorsal double plating (HDDP) was generated using the union of six single dorsal plates to subtract the intersection of the original template dorsal model. A 100 N axial load with 1 Nm bending and torsion moments were applied at the end of the distal radius onto six fracture FE models to investigate the biomechanical differences between the DDP and HDDP approaches. ResultsResults of weighted topology optimization showed that the profile of the HDDP presented a “Y” shape. Simulation results showed that the bone plate stress values for the distal radius fractures fixed with HDDP was much smaller than those with DDP regardless of the type of bone fractures and load conditions. The maximum bone stress value of the DDP approach was much higher than that of HDDP when the distal radius was a complete sagittal articular fracture and partial articular fracture involving lunate fossa. The corresponding maximum bone stress values for different loads might be higher than the ultimate strength of bone (150 MPa) and induced the risk of future bone fractures. ConclusionsIt is concluded that the novel HDDP demonstrated better resistance to functional loads, provided sufficient screw fixation at the articular surface, and can be placed on the dorsal site of the distal radius through the standard dorsal approach to minimize invasive surgeries and eliminate tendon irritations.

Time-dependent topology optimization of bone plates considering bone remodeling

Bone plates have been widely used for the treatment of bone defects and trauma. These fixation plates can stabilize or replace bone tissue to restore appropriate load-bearing functionality. Nevertheless, the use of bone plates may lead to the stress shielding, thereby weakening prosthetic bone substitutes (e.g. bone graft or scaffolds) due to significant change in the biomechanical environment after implantation. To address this issue, we propose a time-dependent topology optimization procedure for the design of bone plates by taking into account bone remodeling. A solid isotropic material penalization (SIMP) model is used to interpolate design variables. The objective is to maximize total bone density within a reconstruction area at the final stage of bone remodeling, subject to a volume constraint of the bone plate and maximum allowable compliance of the prosthetic system. The sensitivity of bone density at the final stage is derived with respect to the topological variables of the plate in a step-wise manner. To facilitate sensitivity analysis, a bone remodeling rule is formulated in two different ways to accommodate a C1continuity. A jaw reconstruction problem is exemplified in this study to demonstrate the effectiveness of the proposed approach. Through this specific case, the non-differentiability issue due to the lazy zone of a remodeling rule is smoothed; and the proposed approach is also compared with that of a time-independent design. The effects of volume fraction and compliance constraints are also investigated to gain further insights into the design of prosthetic substitutes. Together with additive manufacturing technology, the proposed time-dependent topology optimization procedure is expected to form a useful tool for the design of implantable devices ensuring favorable long-term treatment outcomes.

On optimization of a composite bone plate using the selective stress shielding approach

Bone fracture plates are used to stabilize fractures while allowing for adequate compressive force on the fracture ends. Yet the high stiffness of conventional bone plates significantly reduces compression at the fracture site, and can lead to subsequent bone loss upon healing. Fibre-reinforced composite bone plates have been introduced to address this drawback. However, no studies have optimized their configurations to fulfill the requirements of proper healing. In the present study, classical laminate theory and the finite element method were employed for optimization of a composite bone plate. A hybrid composite made of carbon fibre/epoxy with a flax/epoxy core, which was introduced previously, was optimized by varying the laminate stacking sequence and the contribution of each material, in order to minimize the axial stiffness and maximize the torsional stiffness for a given range of bending stiffness. The initial 14×414 possible configurations were reduced to 13 after applying various design criteria. A comprehensive finite element model, validated against a previous experimental study, was used to evaluate the mechanical performance of each composite configuration in terms of its fracture stability, load sharing, and strength in transverse and oblique Vancouver B1 fracture configurations at immediately post-operative, post-operative, and healed bone stages. It was found that a carbon fibre/epoxy plate with an axial stiffness of 4.6MN, and bending and torsional stiffness of 13 and 14N·m2, respectively, showed an overall superiority compared with other laminate configurations. It increased the compressive force at the fracture site up to 14% when compared to a conventional metallic plate, and maintained fracture stability by ensuring the fracture fragments’ relative motions were comparable to those found during metallic plate fixation. The healed stage results revealed that implantation of the titanium plate caused a 40.3% reduction in bone stiffness, while the composite plate lowered the stiffness by 32.9% as compared to the intact femur. This study proposed a number of guidelines for the design of composite bone plates. The findings suggest that a composite bone plate could be customized to allow for moderate compressive force on the fracture ends, while remaining relatively rigid in bending and torsion and strong enough to withstand external loads when a fracture gap is present. The results indicate that the proposed composite bone plate could be a potential candidate for bone fracture plate applications.

The Design and Rapid Prototyping of Surgical Guides and Bone Plates to Support Iliac Free Flaps for Mandible Reconstruction

Sir:FigureThis report describes a novel protocol for the construction of surgical cutting guides and reconstructive titanium bone plates to guide osteotomies according to the preoperative plan and to position and fix an osseous free flap in mandibular reconstruction after cancer removal. Computed tomographic data of a mandible affected by an ameloblastoma were elaborated to produce a virtual surgical plan that included the osteotomy cuts, area of bone resection, and reconstruction. STLfiles were elaborated for use with direct metal laser sintering, and a cutting guide and custom-made bone fixation plate were rapidly prototyped. The operating time was reduced in both the demolition and reconstruction phases. The patient's usual appearance and functionality were restored immediately. The new protocol for mandibular reconstruction is a viable way of reproducing the patient's anatomical contour while giving the surgeon better procedural control and reducing operating time. The innovative technique presented here involves three steps: (1) surgery planning, (2) computer-aided design/computer-aided manufacture and rapid prototyping, and (3) the surgery. High-resolution computed tomographic images of the patient's craniofacial skeleton and soft tissues were acquired using a multidetector computed tomography scanner (HiSpeed CT scanning station; General Electric Company, Fairfield, Conn.). The Digital Imaging and Communications in Medicine–format data were processed by the surgeons using CMF 6.0 software (Materialise, Leuven, Belgium). Three projections of the bone cuts were made in the three spatial axes and imported in Rhino 4.0 software (Robert McNeel & Associates, Seattle, Wash.) to allow the perfect transfer of the surgical plan. The computer-aided design of the surgical device was obtained using Rhino 4.0 software. The first component was a customized cutting guide for use in mandibular resection and to maintain free space after tumor ablation (Fig. 1, above). The second component was a customized reconstructive bone plate to support the iliac free flap (Fig. 1, below). The plate was designed by thickening the outer surface of the mirrored healthy side of the mandible to obtain an ideal mandibular contour and to avoid bone deformities on the side affected by the tumor. Reference notches were also added to delimit the part that would support the free flap. The two components (cutting guide and bone plate) were projected so that the same holes for the screws to fix the guide were used to secure the bone plate that supported the free flap.Fig. 1: The resin model used to train the surgeon with the surgical guide (above) and bone plate (below) in position.The cutting guide and bone plate were manufactured directly using the EOSINT M270 system (Electro Optical Systems, Munich, Germany). EOS CobaltChrome MP1 (Electro Optical Systems) was used to produce the cutting guide. The bone plate was produced with EOS Titanium Ti64 (Electro Optical Systems). A man with an ameloblastoma of the left mandibular body underwent mandibular resection and reconstruction using an iliac free flap. The mandibular cutting guide was fixed to the mandible to reproduce the demolition plan (Fig. 2, above). After mandibular resection, the cutting guide was removed and the reconstructive plate was introduced and fixed using the same holes as for the cutting guide. The reconstructive bone plate supported the iliac free flap in the correct position to restore the patient's original mandibulofacial contour exactly (Fig. 2, below).Fig. 2: Positioning of the surgical guide immediately before making the bone cuts (above) and the bone plate in the final position after connecting the iliac free flap (below).The protocol presented here offers several benefits. First, the virtual environment permitted optimal preoperative planning for tumor ablation: the resection boundaries were chosen accurately in safe tissues. No operating time was consumed by modeling a plate to the native mandible.1–5 Second, the morphology of the opposite hemimandible was mirrored and the reconstruction bone plate was designed using the external healthy cortical bone as a template, reproducing the patient's ideal mandibular contour and avoiding potential bone deformities. Consequently, a good facial soft-tissue contour was attained. Third, no complication occurred postoperatively. The reconstruction plate provided an appropriate bone-plate relationship and maintained the correct occlusal arrangement to avoid condylar distortion and a poor functional outcome. Good masticatory performance was attained 3 weeks postoperatively. Leonardo Ciocca, D.M.D., Ph.D. Section of Prosthodontics, Department of Oral Science Simona Mazzoni Faculty of Medicine Massimiliano Fantini Virtual Reality and Simulation Laboratory, Second Engineering Faculty Claudio Marchetti Faculty of Medicine Roberto Scotti Section of Prosthodontics, Department of Oral Science, Alma Mater Studiorum University of Bologna, Bologna, Italy DISCLOSURE The authors have no financial interest to declare in relation to the content of this article.

Finite element analysis using interfragmentary strain theory for the fracture healing process to which composite bone plates are applied

The present paper deals with finite element analyses to estimate the healing efficiency of fractured long bones to which various composite bone plates are applied. To estimate the callus modulus according to the healing period, interfragmentary strain theory was used, and the iterative process for updating the newly determined callus properties in every finite element was implemented by a user-defined sub-routine constructed by the Python code. The results of analysis revealed that a composite bone plate made of a plain weave carbon/epoxy composite whose Young’s modulus was in the range of 30–70 GPa produced a positive effect on the healing efficiency relieving stress-shielding effect. This result can be used in the detailed design of high-performing composite bone plates to determine more effective shapes and stacking sequences for better healing efficiency.

Simulation of the Effect of Flexible and Rigid Plate Designs on Murine Fracture Healing

Although several histological studies in mice have examined healing of fractures secured with bone plates, no data are available at present on the mechanical response of fractured bone or callus tissue. Here, we simulated the healing response of fractures secured with rigid and flexible bone plate-designs. Using finite element methods, we simulated the maximum principal strain, stress, and strain energy density in the fractured region of mouse femurs under three loading conditions. In the rigid plate-design, the strain energy density increased when compression and bending were loaded and decreased when torsion was loaded. In the flexible plate-design, the strain energy density increased under all loading conditions. Since an increase in the strain energy density indicates an increase in mechanical stimulation, the simulation suggests that the flexible plate design may stimulate bone growth more than the rigid plate design. A favorable bone plate design must be stiff enough to avoid dislocation but flexible enough to provide mechanical stimulation.

Minimally Invasive Bioabsorbable Bone Plates for Rigid Internal Fixation of Mandible Fractures

To optimize design variables of a bioabsorbable bone plate using a finite element model of the mandible and to discover a minimally invasive bioabsorbable bone plate design that can provide the same mechanical stability as a titanium plate. A finite element model of a mandible with a fracture in the body was subjected to bite loads. An analysis was run to determine the principal strain in the fracture callus and von Mises stress in a titanium plate. These values were then set as the limits within which the bioabsorbable bone plate must comply. The model then considered a bone plate made of the polymer poly(L-lactide-co-D,L-lactide) (P[L/DL]LA) 70/30. An optimization routine determined the smallest volume of bioabsorbable bone plate that can perform as well as a titanium bone plate when fixating mandibular fractures. A P(L/DL)LA plate volume of 315 mm(2) with a thickness of 1.5 mm provided as much mechanical stability as a commonly used titanium strut structure of 172 mm(2). The peak plate stress was well below the yield strength of the material. The P(L/DL)LA bioabsorbable bone plate design is as strong as a titanium plate when fixating fractures of the mandible body despite the polymer material having only 6% of the stiffness of the titanium. The P(L/DL)LA plate can be less than half the volume of its strut-style counterpart.

Biomechanical Optimization of Bone Plates Used in Rigid Fixation of Mandibular Symphysis Fractures

To design and optimize a bone plate for fractures of the mandibular symphysis that will provide maximum fracture stability with minimal implanted volume and patient intrusion. The design will be driven by the unique biomechanics specific to this fracture location. A finite element model of a fractured human mandible was created using computed tomography scans. The boundary conditions included simulating molar, canine, and incisal loading. The bone plate design process included a shape optimization routine and design parameter analysis using the model. The optimized bone plate design was finally compared with standard bone plate configurations according to stress and strain measures. Compared with the miniplate combination, the InterFlex III plate, with the same thickness and just 14% more implanted volume, had only 55% of the plate stress and 25% less fracture strain under the strongest loads considered by the model. Compared with the band/fracture plate combination, the InterFlex plate had 88% of the fracture strain and 74% of the plate stress, despite having only 60% of the plate volume. The results have demonstrated that the new optimized plate is a hybrid of fixation hardware with the small profile of the smallest miniplate configuration and the superior fixation strength and safety that exceeds that of the larger fracture plate configuration.

Biomechanical Optimization of Bone Plates Used in Rigid Fixation of Mandibular Fractures

To design and optimize a bone plate for fractures of the mandibular body that will provide maximum fracture stability with minimal implanted volume and patient intrusion. The design will be driven by the unique biomechanics specific to this fracture location. A finite element model of a fractured human mandible was created using tomography scans. Material properties were assigned to the cortical bone, cancellous bone, and dental region. Boundary conditions included simulating a unilateral molar clench and incisal loading. The bone plate design process included a shape optimization routine and design parameter analysis using the model. The optimized bone plate design was finally compared with standard bone plate configurations based on stress and strain measures. For incisal loading, the newly designed InterFlex II plate has 69% of the fracture strain and only 34% of the plate stress of an 8-hole strut plate. For unilateral molar loading, those numbers improve even further to 59% and 27%, respectively. InterFlex II plate stresses are less than or equal to the paired plate configuration, and fracture strain is within 10% of the corresponding paired plate strain under both loading scenarios. In terms of mechanical performance, InterFlex II is in the same class as the commonly used paired plate configuration, despite having only 55% of the implanted volume. A design process focused on shape and design variable optimization can produce bone plates that provide maximum fracture stability with minimum implanted volume.