title: Conceptual finite element study for comparison among superior, anterior, and spiral clavicle plate fixations for midshaft clavicle fracture.
abstract: Open reduction internal fixation technique has been generally accepted for treatment of midshaft clavicle fractures. Both superior and anterior clavicle plates have been reported in clinical or biomechanical researches, while presently the spiral clavicle plate design has been introduced improved biomechanical behavior over conventional designs. In order to objectively realize the multi-directional biomechanical performances among the three geometries for clavicle plate designs, a current conceptual finite element study has been conducted with identical cross-sectional features for clavicle plates. The conceptual superior, anterior, and spiral clavicle plate models were constructed for virtual reduction and fixation to an OTA 15-B1.3 midshaft transverse fracture of clavicle. Mechanical load cases including cantilever bending, axial compression, inferior bending, and axial torsion have been applied for confirming the multi-directional structural stability and implant safety in biomechanical perspective. Results revealed that the anterior clavicle plate model represented lowest plate stress under all loading cases. The superior clavicle plate model showed greater axial compressive stiffness, while the anterior clavicle plate model performed greater rigidity under cantilever bending load. Three model represented similar structural stiffness under axial torsion. Played as a transition structure between superior and anterior clavicle plate, the spiral clavicle plate model revealed comparable results with acceptable multi-directional biomechanical behavior. The concept of spiral clavicle plate design is worth considering in practical application in clinics. Implant safety should be further investigated by evidences in future mechanical tests and clinical observations.
authors.affiliation: Department of Orthopedics, China Medical University and University Hospital, No. 2, Yude Road, North District, Taichung 40402, Taiwan.
authors.forename: Teng-Le
authors.initials: TL
authors.lastname: Huang
authors.affiliation: Technology Translation Centre for Medical Device, Chung Yuan Christian University, No. 200, Chung Pei Road, Chung Li District, Taoyuan 32023, Taiwan.
authors.forename: Wen-Chuan
authors.initials: WC
authors.lastname: Chen
authors.affiliation: Technology Translation Centre for Medical Device, Chung Yuan Christian University, No. 200, Chung Pei Road, Chung Li District, Taoyuan 32023, Taiwan ; Department of Electrical Engineering, Chung Yuan Christian University, No. 200, Chung Pei Road, Chung Li District, Taoyuan 32023, Taiwan.
authors.forename: Kun-Jhih
authors.initials: KJ
authors.lastname: Lin
authors.affiliation: Technology Translation Centre for Medical Device, Chung Yuan Christian University, No. 200, Chung Pei Road, Chung Li District, Taoyuan 32023, Taiwan.
authors.forename: Cheng-Lun
authors.initials: CL
authors.lastname: Tsai
authors.affiliation: Technology Translation Centre for Medical Device, Chung Yuan Christian University, No. 200, Chung Pei Road, Chung Li District, Taoyuan 32023, Taiwan ; Department of Electrical Engineering, Chung Yuan Christian University, No. 200, Chung Pei Road, Chung Li District, Taoyuan 32023, Taiwan.
authors.forename: Kang-Ping
authors.initials: KP
authors.lastname: Lin
authors.affiliation: Technology Translation Centre for Medical Device, Chung Yuan Christian University, No. 200, Chung Pei Road, Chung Li District, Taoyuan 32023, Taiwan ; Department of Physical Therapy and Assistive Technology, National Yang-Ming University, No. 155, Section 2, Linong Street, Beitou District, Taipei 11221, Taiwan . Electronic address: hungwwei@gmail.com.
authors.forename: Hung-Wen
authors.initials: HW
authors.lastname: Wei
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D001860:Bone Plates; D001863:Bone Screws; D002968:Clavicle / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D020342:Finite Element Analysis; D050723:Fractures, Bone; D006801:Humans; D008297:Male; D055595:Mechanical Phenomena; D014057:Tomography, X-Ray Computed
keywords: Clavicle plate; Finite element analysis; Midshaft fracture; Spiral