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Advantage of Multi-Directional Stability of Spiral Clavicle Plate in Treatment of Middle One-Third Clavicle Fracture: A Finite Element Study

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Abstract

Purpose

A high prevalence of middle one-third clavicle fracture has been reported. Both superior and anterior clavicle plates have been used in clinical and biomechanical research, but no decisive advantage for either design has been reported. Spiral clavicle plates have not been well studied in terms of their structural stability and implant safety. The present study analyses the multi-directional biomechanical performance of spiral clavicle plates using the finite element method.

Methods

Two commercial spiral clavicle plate designs were reconstructed to simulate the surgical reduction of a middle one-third oblique clavicle fracture (OTA classification: 15-B1.2). Mechanical load, including axial compression, inferior bending, and axial torsion, was applied to evaluate the multi-directional structural stability and implant safety of the plates.

Results

The two spiral clavicle plate designs enhanced structural stiffness under axial compression, inferior bending, and axial torsion by 59–71%, 38–82%, and 31–46%, respectively, compared to that of the intact clavicle model. Stress concentrations were found around the reconstruction feature of the plate and the screw hole, especially under inferior bending.

Conclusion

The improvement in multi-directional biomechanical stability provided by a spiral clavicle plate is worth considering in clinical applications. Implant safety should be further investigated based on mechanical tests and clinical observations.

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Acknowledgements

We thank Dr. Chang-Hung Huang from the Department of Medical Research at Mackay Memorial Hospital, Taiwan, for technical support and advice regarding finite element analyses.

Funding

No financial support was received for this study.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, The Second Hospital of Jilin University, Changchun, Jilin, China

    Dan-Kai Wu

  2. Technology Translation Centre for Medical Device, Chung Yuan Christian University, Taoyuan, Taiwan

    Wen-Chuan Chen, Kun-Jhih Lin, Cheng-Lun Tsai, Kang-Ping Lin & Hung-Wen Wei

  3. Department of Electrical Engineering, Chung Yuan Christian University, Taoyuan, Taiwan

    Kun-Jhih Lin, Cheng-Lun Tsai & Kang-Ping Lin

  4. Department of Physical Therapy and Assistive Technology, National Yang-Ming University, 155 Linong St., Sec. 2, Beitou Dist., Taipei, 11221, Taiwan

    Hung-Wen Wei

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  1. Dan-Kai Wu
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Wen-Chuan Chen, Kun-Jhih Lin, and Hung-Wen Wei. The first draft of the manuscript was written by Dan-Kai Wu and Wen-Chuan Chen, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Hung-Wen Wei.

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Wu, DK., Chen, WC., Lin, KJ. et al. Advantage of Multi-Directional Stability of Spiral Clavicle Plate in Treatment of Middle One-Third Clavicle Fracture: A Finite Element Study. J. Med. Biol. Eng. 41, 405–411 (2021). https://doi.org/10.1007/s40846-021-00635-x

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  • DOI: https://doi.org/10.1007/s40846-021-00635-x

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