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生物相容性材料与钛在个体化锁定接骨板治疗锁骨中段骨折中的应用比较:一项有限元分析研究。

Comparison of the use of biocompatible materials and titanium in the treatment of midshaft clavicle fractures with a patient-specific plate: a finite element analysis study.

机构信息

Department of Orthopaedics and Traumatology, Konya City Hospital, Konya, 42020, Türkiye.

Department of Orthopaedics and Traumatology, Kahramanmaraş Necip Fazıl City Hospital, Kahramanmaraş, 46050, Türkiye.

出版信息

Arch Orthop Trauma Surg. 2024 Aug;144(8):3255-3266. doi: 10.1007/s00402-024-05449-5. Epub 2024 Jul 15.


DOI:10.1007/s00402-024-05449-5
PMID:39008077
Abstract

BACKGROUND: Clavicular midshaft fractures treated with titanium plates may encounter complications like implant failure. We assess if alternative biocompatible materials suchs as PLA, PLA/HA, PEEK offer comparable stability. Our study evaluates the biomechanical performance of these materials in surgical management of midshaft clavicle fractures. METHODS: We simulated a personalized fixation implant with four different materials and conducted finite element analysis in ANSYS to assess maximum von Mises stress (MvMs). RESULTS: The MvMs occurring on the plates, screws, clavicle, and fracture site were recorded. MvMs on titanium material at the 6th hole level (764.79 MPa) and the 6th screw level (503.38 MPa), with the highest stresses observed at 48.52 MPa on the lateral clavicle at the 1st hole level and 182.27 MPa on the medial clavicle at the 6th hole level. In PLA material analyses, the highest MvMs were observed at the 3rd hole level (340.6 MPa) and the 3rd screw level (157.83 MPa), with peak stresses at 379.63 MPa on the lateral clavicle fracture line and 505.44 MPa on the medial clavicle fracture line. In PLA/HA material analyses, the highest MvMs were at the 3rd hole (295.99 MPa) and 3rd screw (128.27 MPa), with peak stresses at 220.33 MPa on the lateral clavicle and 229.63 MPa on the medial clavicle fracture line. In PEEK material analyses, the highest MvMs were at the 3rd hole (234.74 MPa) and 6th screw (114.48 MPa), with peak stresses at 184.36 MPa on the lateral clavicle and 180.1 MPa on the medial clavicle. CONCLUSION: Our findings indicate that titanium material shows significantly higher stresses on plates and screws compared to those on the clavicle, suggesting a risk of implant failure. PLA and PLA/HA were inadequate for fixation. Although stress on the plate with PEEK material is higher than on the clavicle, it remains lower than titanium, indicating potential stability at fracture site. Further research is needed to confirm these findings.

摘要

背景:锁骨中段骨折采用钛板治疗可能会出现植入物失败等并发症。我们评估了 PLA、PLA/HA、PEEK 等其他生物相容性材料是否具有相当的稳定性。本研究评估了这些材料在锁骨中段骨折手术治疗中的生物力学性能。

方法:我们模拟了一种个性化的固定植入物,使用四种不同的材料,并在 ANSYS 中进行有限元分析,以评估最大 von Mises 应力(MvMs)。

结果:记录了钛板、螺钉、锁骨和骨折部位的 MvMs。钛材料在第 6 孔水平(764.79 MPa)和第 6 个螺钉水平(503.38 MPa)的 MvMs 最高,在第 1 个孔水平的外侧锁骨处观察到最高 48.52 MPa 的 MvMs,在第 6 个孔水平的内侧锁骨处观察到 182.27 MPa 的 MvMs。在 PLA 材料分析中,在第 3 个孔水平(340.6 MPa)和第 3 个螺钉水平(157.83 MPa)观察到最高的 MvMs,在外侧锁骨骨折线处观察到最高 379.63 MPa 的峰值应力,在 medial clavicle fracture line 处观察到 505.44 MPa 的峰值应力。在 PLA/HA 材料分析中,在第 3 个孔(295.99 MPa)和第 3 个螺钉(128.27 MPa)处观察到最高的 MvMs,在外侧锁骨处观察到最高 220.33 MPa 的峰值应力,在 medial clavicle fracture line 处观察到 229.63 MPa 的峰值应力。在 PEEK 材料分析中,在第 3 个孔(234.74 MPa)和第 6 个螺钉(114.48 MPa)处观察到最高的 MvMs,在外侧锁骨处观察到最高 184.36 MPa 的峰值应力,在 medial clavicle 处观察到最高 180.1 MPa 的峰值应力。

结论:我们的研究结果表明,钛材料在板和螺钉上的应力明显高于在锁骨上的应力,提示存在植入物失败的风险。PLA 和 PLA/HA 不适合固定。尽管 PEEK 材料板上的应力高于锁骨,但仍低于钛,表明骨折部位具有潜在的稳定性。需要进一步的研究来证实这些发现。

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引用本文的文献

[1]
Biomechanical insights through finite element analysis of Bennett fracture fixation: a comparative study of four surgical techniques.

J Orthop Surg Res. 2025-1-23

本文引用的文献

[1]
Single-plate versus double-plate comparison in the surgical treatment of comminuted clavicle fractures: Is the secondary plate reliable?

Medicine (Baltimore). 2023-12-22

[2]
3D printing technology combined with personalized plates for complex distal intra-articular fractures of the trimalleolar ankle.

Sci Rep. 2023-12-19

[3]
A natural experiment study: Low-profile double plating versus single plating techniques in midshaft clavicle fractures-Study protocol.

PLoS One. 2023

[4]
American Academy of Orthopaedic Surgeons Clinical Practice Guideline Summary on the Treatment of Clavicle Fractures.

J Am Acad Orthop Surg. 2023-9-15

[5]
Four-Corner Arthrodesis with a Dorsal Locking PEEK Plate: A Retrospective Case Series.

J Wrist Surg. 2022-10-13

[6]
Personalized Medicine in Orthopaedic Surgery: The Case of Spine Surgery.

J Am Acad Orthop Surg. 2023-9-1

[7]
Pre-Operative Planning in Complex Deformities and Use of Patient-Specific UNiD Instrumentation.

Global Spine J. 2022-4

[8]
Long Term Results of a Rotating Hinge Total Knee Prosthesis With Carbon-Fiber Reinforced Poly-Ether-Ether-Ketone (CFR-PEEK) as Bearing Material.

Front Bioeng Biotechnol. 2022-3-4

[9]
Palmar plating of distal radius fractures : 3-year follow-up with titanium and PEEK plates give similar outcomes.

Acta Orthop Belg. 2021-9

[10]
Finite element analysis of dual small plate fixation and single plate fixation for treatment of midshaft clavicle fractures.

J Orthop Surg Res. 2020-4-15

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