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Biomechanical analysis of internal fixation system stability for tibial plateau fractures.

作者信息

Wei Guoqiang, Niu Xiaofen, Li Yuan, Chang Tingjie, Zhang Jianfang, Wang Haiyan, Li Xiaohe, He Yujie, Wang Ruijiang, Tian Fei, Xu Yangyang

机构信息

Department of Rehabilitation Medicine, Changzhi Medical College Affiliated Changzhi People's Hospital, Changzhi, China.

Department of Orthopedics, Changzhi Medical College Affiliated Peace Hospital, Changzhi, China.

出版信息

Front Bioeng Biotechnol. 2023 Jun 14;11:1199944. doi: 10.3389/fbioe.2023.1199944. eCollection 2023.


DOI:10.3389/fbioe.2023.1199944
PMID:37388773
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10303893/
Abstract

Complex bone plateau fractures have been treated with bilateral plate fixation, but previous research has overemphasized evaluating the effects of internal fixation design, plate position, and screw orientation on fracture fixation stability, neglecting the internal fixation system's biomechanical properties in postoperative rehabilitation exercises. This study aimed to investigate the mechanical properties of tibial plateau fractures after internal fixation, explore the biomechanical mechanism of the interaction between internal fixation and bone, and make suggestions for early postoperative rehabilitation and postoperative weight-bearing rehabilitation. By establishing the postoperative tibia model, the standing, walking and running conditions were simulated under three axial loads of 500 N, 1000 N, and 1500 N. Accordingly, finite element analysis (FEA) was performed to analyze the model stiffness, displacement of fractured bone fragments, titanium alloy plate, screw stress distribution, and fatigue properties of the tibia and the internal fixation system under various conditions. The stiffness of the model increased significantly after internal fixation. The anteromedial plate was the most stressed, followed by the posteromedial plate. The screws at the distal end of the lateral plate, the screws at the anteromedial plate platform and the screws at the distal end of the posteromedial plate are under greater stress, but at a safe stress level. The relative displacement of the two medial condylar fracture fragments varied from 0.002-0.072 mm. Fatigue damage does not occur in the internal fixation system. Fatigue injuries develop in the tibia when subjected to cyclic loading, especially when running. The results of this study indicate that the internal fixation system tolerates some of the body's typical actions and may sustain all or part of the weight early in the postoperative period. In other words, early rehabilitative exercise is recommended, but avoid strenuous exercise such as running.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f62/10303893/3b62b441cb67/fbioe-11-1199944-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f62/10303893/9a3c4d18a0ed/fbioe-11-1199944-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f62/10303893/6891cd4acd6f/fbioe-11-1199944-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f62/10303893/9a6d2c9960e2/fbioe-11-1199944-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f62/10303893/b216517d5bde/fbioe-11-1199944-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f62/10303893/3b92d52ec5f6/fbioe-11-1199944-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f62/10303893/57e62c227354/fbioe-11-1199944-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f62/10303893/69d0bcfa90cb/fbioe-11-1199944-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f62/10303893/d87b2f42d826/fbioe-11-1199944-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f62/10303893/3b62b441cb67/fbioe-11-1199944-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f62/10303893/9a3c4d18a0ed/fbioe-11-1199944-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f62/10303893/6891cd4acd6f/fbioe-11-1199944-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f62/10303893/9a6d2c9960e2/fbioe-11-1199944-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f62/10303893/b216517d5bde/fbioe-11-1199944-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f62/10303893/3b92d52ec5f6/fbioe-11-1199944-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f62/10303893/57e62c227354/fbioe-11-1199944-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f62/10303893/69d0bcfa90cb/fbioe-11-1199944-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f62/10303893/d87b2f42d826/fbioe-11-1199944-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f62/10303893/3b62b441cb67/fbioe-11-1199944-g009.jpg

相似文献

[1]
Biomechanical analysis of internal fixation system stability for tibial plateau fractures.

Front Bioeng Biotechnol. 2023-6-14

[2]
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[6]
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[7]
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[8]
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[9]
Stress and stability of plate-screw fixation and screw fixation in the treatment of Schatzker type IV medial tibial plateau fracture: a comparative finite element study.

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[10]
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引用本文的文献

[1]
Segmentation and finite element analysis in orthopaedic trauma.

3D Print Med. 2025-7-21

[2]
Title of the study: finite element analysis of five internal fixation modalities for Schatzker type IV‒C tibial plateau fractures.

BMC Musculoskelet Disord. 2025-5-23

[3]
[Research progress on biomechanics for internal fixation in tibial plateau fracture].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2024-1-15

本文引用的文献

[1]
A finite element analysis of the supportive effect of a new type of rotary support plate on lateral tibial plateau fractures.

Ann Transl Med. 2022-9

[2]
Stability of internal fixation systems based on different subtypes of Schatzker II fracture of the tibial plateau: A finite element analysis.

Front Bioeng Biotechnol. 2022-9-7

[3]
Comparative analysis of tibial plateau fracture osteosynthesis: A finite element study.

J Mech Behav Biomed Mater. 2022-10

[4]
Biomechanical design of a new percutaneous locked plate for comminuted proximal tibia fractures.

Med Eng Phys. 2022-6

[5]
The Study of Biomechanics and Clinical Anatomy on a Novel Plate Designed for Posterolateral Tibial Plateau Fractures Anterolateral Approach.

Front Bioeng Biotechnol. 2022-3-8

[6]
A proposal of a new algorithm for decision-making approaches in open reduction and internal fixation of complex tibial plateau fractures - SOTA algorithm (Spanish Orthopaedic Trauma Association).

Injury. 2021-7

[7]
A finite element analysis of relationship between fracture, implant and tibial tunnel.

Sci Rep. 2021-1-19

[8]
Biomechanical aspects of the posteromedial split in bicondylar tibial plateau fractures-a finite-element investigation.

Eur J Trauma Emerg Surg. 2020-12

[9]
Finite element analysis of Bi-condylar Tibial Plateau fractures to assess the effect of coronal splits.

Med Eng Phys. 2020-10

[10]
Retrospective analysis of 514 cases of tibial plateau fractures based on morphology and injury mechanism.

J Orthop Surg Res. 2019-8-23

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