Biomechanical assessment of single LISS versus double-plate osteosynthesis in the AO type 33-C2 fractures: A finite element analysis. Issue 12 (December 2018)

• Record Type: Journal Article
• Authors: Zhang, Wei; Li, Jiantao; Zhang, Hao; Wang, Menglin; Li, Lianting; Zhou, Jianfeng; Guo, Hui; Li, Yang; Tang, Peifu
• Is Part Of: Injury. Volume 49:Issue 12(2018)
• Page Start: 2142
• Page End: 2146
• Publication Date: 2018-12
• Subjects: Unstable distal femoral fractures -- Finite element analysis -- LISS plate -- Double plates; Wounds and injuries -- Surgery -- Periodicals; Accidents -- Periodicals; Wounds and Injuries -- surgery -- Periodicals; Lésions et blessures -- Chirurgie -- Périodiques; Electronic journals; Electronic journals; 617.1
• DOI: 10.1016/j.injury.2018.10.011
• Languages: English
• ISSNs: 0020-1383

Abstract

Highlights: The medial plate should be shorter and smaller in its dimensions than the lateral plate because of avoiding the stress-riser at the proximal end of the plate. Fixation of at least eight cortices of the both side of the fragment is obtained using LISS in the lateral side, and the medial plate should be fixed with at least three bicortical screws both distally and proximally. The double plates is more effective scenario using in the distal femoral fractures, particular in unstable fractures with joint involvement. It is available and safe to add a medial plate in the distal femur clinically. Abstract: Objectives: In the present study, we assessed the biomechanical advantage between the single LISS and double-plate used in AO type 33-C2 fractures with the method of finite element analysis, which will help surgeons choose the optimal therapy to the unstable distal femoral fracture. Methods: The AO type 33-C2 fractures and the models of LISS plate and medial plate was constructed in 3-matic software and UG-NX software respectively. We then assembled the single plate and the double-plate to the fracture model separately to form the fixation models. After meshing the models' elements, we used the Abaqus software to perform the finite element analysis. Values of peak Von Mises Stress (VMS) on the plate, maximum deformation of the models and the distance changes of the fracture gap were used to capture the mechanical factors in this study. Results: Our results indicated that the single LISS underwent 1.2 times higher amount of stress than the double-plate (316.0 MPa VS 281.6 MPa). And the medial plate dispersed some stresses (the maximum stress is 47.4 MPa). Single-plate generated 3 times greater bending angle than double-plate (0.6° VS 0.2°). The bending angles of the single and double-fixation-fracture models are 0.9° and 0.3° respectively. The maximum distance changes of the fracture gap in the single-plate model was 2 times higher than that of double-plate model (2.6 mm VS 1.3 mm). In the torsional load analysis, peak VMS of the single and double model was 1.0 MPa and 0.8 MPa respectively. And the bending angle was 0.8° in the single model and 0.4° in the double model. Conclusions: The double-plate is more effective scenario using in the distal femoral fractures, particular in unstable fractures with joint involvement.