A finite element analysis of petal-shaped poly-axial locking plate fixation in treatment of Y-shaped patellar fracture_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

MENG Depeng , OUYANG Yueping ,  HOU Chunlin

Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, P.R.China;

Corresponding?author：

HOU Chunlin, Email: chunlin_hou@163.com

Keywords：

Patellar fracture; poly-axial locking plate; finite element analysis; biomechanics

DOI：

10.7507/1002-1892.201706054

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To establish the finite element model of Y-shaped patellar fracture fixed with titanium-alloy petal-shaped poly-axial locking plate and to implement the finite element mechanical analysis. Methods The three-dimensional model was created by software Mimics 19.0, Rhino 5.0, and 3-Matic 11.0. The finite element analysis was implemented by ANSYS Workbench 16.0 to calculate the Von-Mises stress and displacement. Before calculated, the upper and lower poles of the patella were constrained. The 2.0, 3.5, and 4.4 MPa compressive stresses were applied to the 1/3 patellofemoral joint surface of the lower, middle, and upper part of the patella respectively, and to simulated the force upon patella when knee flexion of 20, 45, and 90°. Results The number of nodes and elements of the finite element model obtained was 456 839 and 245 449, respectively. The max value of Von-Mises stress of all the three conditions simulated was 151.48 MPa under condition simulating the knee flexion of 90°, which was lower than the yield strength value of the titanium-alloy and patella. The max total displacement value was 0.092 8 mm under condition simulating knee flexion of 45°, which was acceptable according to clinical criterion. The stress concentrated around the non-vertical fracture line and near the area where the screws were sparse. Conclusion The titanium-alloy petal-shaped poly-axial locking plate have enough biomechanical stiffness to fix the Y-shaped patellar fracture, but the result need to be proved in future.

Citation： MENG Depeng, OUYANG Yueping, HOU Chunlin. A finite element analysis of petal-shaped poly-axial locking plate fixation in treatment of Y-shaped patellar fracture. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(12): 1456-1461. doi: 10.7507/1002-1892.201706054 Copy

1.	Bostman O, Kiviluoto O, Nirhamo J. Comminuted displaced fractures of the patella. Injury, 1981, 13(3): 196-202.
2.	Bostrom A. Fracture of the patella. A study of 422 patellar fractures. Acta Orthop Scand Suppl, 1972, 143: 1-80.
3.	Wild M, Windolf J, Flohé S. Fractures of the patella. Unfallchirurg, 2010, 113(5): 401-411.
4.	Melvin JS, Mehta S. Patellar fractures in adults. J Am Acad Orthop Surg, 2011, 19(4): 198-207.
5.	Rogge D, Oestern HJ, Gossé F. Patella fracture. Therapy and results. Orthopade, 1985, 14(4): 266-280.
6.	蒙德鵬, 歐陽躍平, 陳寅生, 等. X 形鎖定鎖定板加縫線環扎固定治療橫行髕骨骨折. 中國矯形外科雜志, 2017, 25(10): 884-887.
7.	何澤陽. 微型鋼板固定髕骨分層骨折的有限元模型建立和分析. 石家莊: 河北醫科大學, 2016.
8.	管志海, 王勤業, 王以進, 等. 髕骨骨折內固定板的生物力學性能. 中國組織工程研究, 2014, 18(4): 559-564.
9.	Fernandez JW, Hunter PJ. An anatomically based patient-specific finite element model of patella articulation: towards a diagnostic tool. Biomech Model Mechanobiol, 2005, 4(1): 20-38.
10.	Zhang J, Ebraheim N, Li M, et al. External fixation using locking plate in distal tibial fracture: a finite element analysis. Eur J Orthop Surg Traumatol, 2015, 25(6): 1099-1104.
11.	Niinomi M. Mechanical properties of biomedical titanium alloys. Materials Science and Engineering: A, 1998, 243(1-2): 231-236.
12.	Aziz MSR, Dessouki O, Samiezadeh S, et al. Biomechanical analysis using FEA and experiments of a standard plate method versus three cable methods for fixing acetabular fractures with simultaneous THA. Med Eng Phys, 2017, 46: 71-78.
13.	Zdero R, Olsen M, Bougherara H, et al. Cancellous bone screw purchase: a comparison of synthetic femurs, human femurs, and finite element analysis. Proc Inst Mech Eng H, 2008, 222: 1175-1183.
14.	Grelsamer RP, Weinstein CH. Applied biomechanics of the patella. Clin Orthop Relat Res, 2001, (389): 9-14.
15.	Huberti HH, Hayes WC. Patellofemoral contact pressures. The influence of q-angle and tendofemoral contact. J Bone Joint Surg (Am), 1984, 66(5): 715-724.
16.	Silva MET, Brand?o S, Parente MPL, et al. Biomechanical properties of the pelvic floor muscles of continent and incontinent women using an inverse finite element analysis. Comput Methods Biomech Biomed Engin, 2017, 20(8): 842-852.
17.	Moon SY, Lim YJ, Kim MJ, et al. Three-dimensional finite element analysis of platform switched implant. J Adv Prosthodont, 2017, 9(1): 31-37.
18.	Macedo JP, Pereira J, Faria J, et al. Finite element analysis of stress extent at peri-implant bone surrounding external hexagon or Morse taper implants. J Mech Behav Biomed Mater, 2017, 71: 441-447.
19.	Liu JM, Zhang Y, Zhou Y, et al. The effect of screw tunnels on the biomechanical stability of vertebral body after pedicle screws removal: a finite element analysis. Int Orthop, 2017, 41(6): 1183-1187.
20.	崔紅新, 程方榮, 王健智. 有限元法及其在生物力學中的應用. 中醫正骨, 2005, 17(1): 53-55.
21.	徐洪璋, 余斌. 髕骨骨折 AO 張力帶內固定有限元模型的建立和分析. 中國組織工程研究與臨床康復, 2011, 15(13): 2339-2344.
22.	王以進, 王介麟. 骨科生物力學. 北京: 人民軍醫出版社, 1989: 291-301.

1. Bostman O, Kiviluoto O, Nirhamo J. Comminuted displaced fractures of the patella. Injury, 1981, 13(3): 196-202.
2. Bostrom A. Fracture of the patella. A study of 422 patellar fractures. Acta Orthop Scand Suppl, 1972, 143: 1-80.
3. Wild M, Windolf J, Flohé S. Fractures of the patella. Unfallchirurg, 2010, 113(5): 401-411.
4. Melvin JS, Mehta S. Patellar fractures in adults. J Am Acad Orthop Surg, 2011, 19(4): 198-207.
5. Rogge D, Oestern HJ, Gossé F. Patella fracture. Therapy and results. Orthopade, 1985, 14(4): 266-280.
6. 蒙德鵬, 歐陽躍平, 陳寅生, 等. X 形鎖定鎖定板加縫線環扎固定治療橫行髕骨骨折. 中國矯形外科雜志, 2017, 25(10): 884-887.
7. 何澤陽. 微型鋼板固定髕骨分層骨折的有限元模型建立和分析. 石家莊: 河北醫科大學, 2016.
8. 管志海, 王勤業, 王以進, 等. 髕骨骨折內固定板的生物力學性能. 中國組織工程研究, 2014, 18(4): 559-564.
9. Fernandez JW, Hunter PJ. An anatomically based patient-specific finite element model of patella articulation: towards a diagnostic tool. Biomech Model Mechanobiol, 2005, 4(1): 20-38.
10. Zhang J, Ebraheim N, Li M, et al. External fixation using locking plate in distal tibial fracture: a finite element analysis. Eur J Orthop Surg Traumatol, 2015, 25(6): 1099-1104.
11. Niinomi M. Mechanical properties of biomedical titanium alloys. Materials Science and Engineering: A, 1998, 243(1-2): 231-236.
12. Aziz MSR, Dessouki O, Samiezadeh S, et al. Biomechanical analysis using FEA and experiments of a standard plate method versus three cable methods for fixing acetabular fractures with simultaneous THA. Med Eng Phys, 2017, 46: 71-78.
13. Zdero R, Olsen M, Bougherara H, et al. Cancellous bone screw purchase: a comparison of synthetic femurs, human femurs, and finite element analysis. Proc Inst Mech Eng H, 2008, 222: 1175-1183.
14. Grelsamer RP, Weinstein CH. Applied biomechanics of the patella. Clin Orthop Relat Res, 2001, (389): 9-14.
15. Huberti HH, Hayes WC. Patellofemoral contact pressures. The influence of q-angle and tendofemoral contact. J Bone Joint Surg (Am), 1984, 66(5): 715-724.
16. Silva MET, Brand?o S, Parente MPL, et al. Biomechanical properties of the pelvic floor muscles of continent and incontinent women using an inverse finite element analysis. Comput Methods Biomech Biomed Engin, 2017, 20(8): 842-852.
17. Moon SY, Lim YJ, Kim MJ, et al. Three-dimensional finite element analysis of platform switched implant. J Adv Prosthodont, 2017, 9(1): 31-37.
18. Macedo JP, Pereira J, Faria J, et al. Finite element analysis of stress extent at peri-implant bone surrounding external hexagon or Morse taper implants. J Mech Behav Biomed Mater, 2017, 71: 441-447.
19. Liu JM, Zhang Y, Zhou Y, et al. The effect of screw tunnels on the biomechanical stability of vertebral body after pedicle screws removal: a finite element analysis. Int Orthop, 2017, 41(6): 1183-1187.
20. 崔紅新, 程方榮, 王健智. 有限元法及其在生物力學中的應用. 中醫正骨, 2005, 17(1): 53-55.
21. 徐洪璋, 余斌. 髕骨骨折 AO 張力帶內固定有限元模型的建立和分析. 中國組織工程研究與臨床康復, 2011, 15(13): 2339-2344.
22. 王以進, 王介麟. 骨科生物力學. 北京: 人民軍醫出版社, 1989: 291-301.

Chinese Journal of Reparative and Reconstructive Surgery

A finite element analysis of petal-shaped poly-axial locking plate fixation in treatment of Y-shaped patellar fracture

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