title: Can we safely deform a plate to fit every bone? Population-based fit assessment and finite element deformation of a distal tibial plate.
abstract: Anatomically precontoured plates are commonly used to treat periarticular fractures. A well-fitting plate can be used as a tool for anatomical reduction of the fractured bone. Recent studies highlighted that some plates fit poorly for many patients due to considerable shape variations between bones of the same anatomical site. While it is impossible to design one shape that fits all, it is also burdensome for the manufacturers and hospitals to produce, store and manage multiple plate shapes without the certainty of utilization by a patient population. In this study, we investigated the number of shapes required for maximum fit within a given dataset, and if they could be obtained by manually deforming the original plate. A distal medial tibial plate was automatically positioned on 45 individual tibiae, and the optimal deformation was determined iteratively using finite element analysis simulation. Within the studied dataset, we found that: (i) 89% fit could be achieved with four shapes, (ii) 100% fit was impossible through mechanical deformation, and (iii) the deformations required to obtain the four plate shapes were safe for the stainless steel plate for further clinical use. The proposed framework is easily transferable to other orthopaedic plates.
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, QLD 4059, Australia; Department of Biological and Agricultural Engineering, Faculty of Engineering, Universiti Putra Malaysia, Selangor 43400, Malaysia. Electronic address: hazreen@upm.edu.my.
authors.forename: Hazreen
authors.initials: H
authors.lastname: Harith
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, QLD 4059, Australia.
authors.forename: Beat
authors.initials: B
authors.lastname: Schmutz
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, QLD 4059, Australia.
authors.forename: Javad
authors.initials: J
authors.lastname: Malekani
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, QLD 4059, Australia; Trauma Services, Princess Alexandra Hospital, QLD 4012, Australia.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Schuetz
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, QLD 4059, Australia; School of Chemistry, Physics and Mechanical Engineering, Science and Engineering Faculty, Queensland University of Technology, QLD 4000, Australia.
authors.forename: Prasad K
authors.initials: PK
authors.lastname: Yarlagadda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D005260:Female; D020342:Finite Element Analysis; D006801:Humans; D008297:Male; D055595:Mechanical Phenomena; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D013977:Tibia / Q000601:surgery*
keywords: 3D; Bending; Deformation; FEA; Fit assessment; Fracture; Implant; Tibia