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Research and Reviews : Journal of Surgery Original Research

Wave plate; what is the angle of its central curved segment which provides biomechanically optimal stability for femoral shaft fracture?:A 3-D Finite Analysis

  1. Man-Yong Han
  2. Mun-Sik Ko
  3. Man-Gil Han
  4. Tong-Won Mun
  5. Sung-Chol Ri
  6. Tae-Bom Choe

Abstract

Even though intramedullary nailing of femoral shaft fracture is the standard surgical treatment as it is in tibial fracture, plate fixation might be a choice when the fracture involves open growth plate, patients are of shorter stature or have narrow canals. In these cases, fixation techniques with plate and screws, for example, percutaneous procedures involving wave plate, are useful thanks to minimal invasion and preservation of biological environment surrounding the fractures. However, this shape results in restricted weight bearing for postoperative 2 to 3 months and no availability to poor soft-tissue situation due to prominence. The purpose of the present study was to recommend optimal angle of central curved segment of wave plate when sustained fixation of femoral shaft fractures with wave plating by comparing biomechanical stability provided by fixations of wave plates with different angles of central curved segment. Method: Based on CT scans of the femur of human and wave plate, 3D-finite element models of femoral shaft fractures stabilized by wave plating were built to be analyzed for their biomechanical characteristics with ANSYS WORKBENCH programme when applied 3 types of loads including axial compression, antero-posterior bending and torsion. Results: The wave plate with 15° of central curved segment presented minimum stiffness of 122.0MPa, 52.2MPa, and displacements of 4.0mm, 2.0mm compared with those measured in fixations by wave plates with 10°, 20° and 25° of central curved segments under axial compression and antero-posterior bending. Torsion loads, however, produced stiffness which increase and displacements which decrease according to increase of the angles. Conclusion: It is biomechanically the most stable to choose a wave plate with 15° of central curved segment, when treated femoral shaft fractures with wave plating.

Keywords

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