Finite element analysis of double-plate fixation using reversed locking compression-distal femoral plates for Vancouver B1 periprosthetic femoral fractures.

Abstract

BACKGROUND:

Internal fixation is recommended for treating Vancouver B1 periprosthetic femoral fractures. Although several fixation procedures have been developed with high fixation stability and union rates, long-term weight-bearing constructs are still lacking. Therefore, the aim of the present study was to evaluate the stability of a double-plate procedure using reversed contralateral locking compression-distal femoral plates for fixation of Vancouver B1 periprosthetic femoral fractures under full weight-bearing.

METHODS:

Single- and double-plate fixation procedures for locking compression-distal femoral plates were analysed under an axial load of 1,500 N by finite element analysis and biomechanical loading tests. A vertical loading test was performed to the prosthetic head, and the displacements and strains were calculated based on load-displacement and load-strain curves generated by the static compression tests.

RESULTS:

The finite element analysis revealed that double-plate fixation significantly reduced stress concentration at the lateral plate place on the fracture site. Under full weight-bearing, the maximum von Mises stress in the lateral plate was 268 MPa. On the other hand, the maximum stress in the single-plating method occurred at the defect level of the femur with a maximum stress value of 1,303 MPa. The principal strains of single- and double-plate fixation were 0.63 % and 0.058 %, respectively. Consistently, in the axial loading test, the strain values at a 1,500 N loading of the single- and double-plate fixation methods were 1,274.60 ± 11.53 and 317.33 ± 8.03 (× 10- 6), respectively.

CONCLUSIONS:

The present study suggests that dual-plate fixation with reversed locking compression-distal femoral plates may be an excellent treatment procedure for patients with Vancouver B1 fractures, allowing for full weight-bearing in the early postoperative period.

• Authors: Daisuke Takahashi, Yoshihiro Noyama, Tsuyoshi Asano, Tomohiro Shimizu, Tohru Irie, Mohamad Alaa Terkawi, Norimasa Iwasaki
• Journal: BMC musculoskeletal disorders (BMC Musculoskelet Disord) Vol. 22 Issue 1 Pg. 276 (Mar 13 2021) ISSN: 1471-2474 [Electronic] England
• PMID: 33714273 (Publication Type: Journal Article)

Topics

• Biomechanical Phenomena
• Bone Plates
• Femoral Fractures (diagnostic imaging, surgery)
• Femur
• Finite Element Analysis
• Fracture Fixation, Internal
• Humans
• Periprosthetic Fractures (diagnostic imaging, etiology, surgery)