Comparison of the use of biocompatible materials and titanium in the treatment of midshaft clavicle fractures with a patient-specific plate: a finite element analysis study

• Published in: Archives of orthopaedic and trauma surgery 2024-08, Vol.144 (8), p.3255-3266
• Main Authors: Yurteri, Ahmet, Mercan, Numan, Uğur, Levent
• Format: Article
• Language: English
• Subjects: Benzophenones; Biocompatibility; Biocompatible Materials; Biomechanical Phenomena; Bone Plates; Bone Screws; Clavicle - injuries; Clavicle - surgery; Durapatite; Finite Element Analysis; Fracture Fixation, Internal - instrumentation; Fracture Fixation, Internal - methods; Fractures, Bone - surgery; Humans; Ketones; Materials Testing; Medicine; Medicine & Public Health; Orthopaedic Surgery; Orthopedics; Polyesters; Polyethylene Glycols; Polymers; Titanium
• ISSN: 1434-3916; 0936-8051; 1434-3916
• DOI: 10.1007/s00402-024-05449-5

Background Clavicular midshaft fractures treated with titanium plates may encounter complications like implant failure. We assess if alternative biocompatible materials suchs as PLA, PLA/HA, PEEK offer comparable stability. Our study evaluates the biomechanical performance of these materials in surgical management of midshaft clavicle fractures. Methods We simulated a personalized fixation implant with four different materials and conducted finite element analysis in ANSYS to assess maximum von Mises stress (MvMs). Results The MvMs occurring on the plates, screws, clavicle, and fracture site were recorded. MvMs on titanium material at the 6th hole level (764.79 MPa) and the 6th screw level (503.38 MPa), with the highest stresses observed at 48.52 MPa on the lateral clavicle at the 1st hole level and 182.27 MPa on the medial clavicle at the 6th hole level. In PLA material analyses, the highest MvMs were observed at the 3rd hole level (340.6 MPa) and the 3rd screw level (157.83 MPa), with peak stresses at 379.63 MPa on the lateral clavicle fracture line and 505.44 MPa on the medial clavicle fracture line. In PLA/HA material analyses, the highest MvMs were at the 3rd hole (295.99 MPa) and 3rd screw (128.27 MPa), with peak stresses at 220.33 MPa on the lateral clavicle and 229.63 MPa on the medial clavicle fracture line. In PEEK material analyses, the highest MvMs were at the 3rd hole (234.74 MPa) and 6th screw (114.48 MPa), with peak stresses at 184.36 MPa on the lateral clavicle and 180.1 MPa on the medial clavicle. Conclusion Our findings indicate that titanium material shows significantly higher stresses on plates and screws compared to those on the clavicle, suggesting a risk of implant failure. PLA and PLA/HA were inadequate for fixation. Although stress on the plate with PEEK material is higher than on the clavicle, it remains lower than titanium, indicating potential stability at fracture site. Further research is needed to confirm these findings.