Custom Clavicle Fixation Plates Optimize Fracture Healing

Computer-designed clavicle fracture fixation plates provide geometrical and stiffness features that can mechanically outperform commercial plates, claims a new study.

Researchers at Katholieke Universiteit Leuven (KU Leuven; Belgium) fabricated patient-specific thin clavicle fracture fixation plates through computer modeling, and then compared their biomechanical performance with commercial plates by examining geometric fit, anatomical outline, stresses, inter-fragmentary motion, and muscle attachment site (MAS) conformability, using finite element analysis with physiological loading and boundary conditions. The evaluation revealed better geometrical fit of the patient-specific plate, as well as an improved fracture reduction.

Superior mechanical performance--in terms of all investigated outcomes--of the thin patient-specific plate was shown, providing better alignment with the patient-specific geometry, and obviating the need for MAS release to allow fixation. In addition, displacements between fracture fragments were lower in the case of the thinner patient-specific plate, both when a fracture gap and no fracture gap were present. The study was published on October 19, 2021, in Journal of Orthopaedic Research.

“Due to the patient-specific geometry and reduced thickness, these fixation plates are expected to decrease the operation time, as intraoperative contouring will become irrelevant, and to decrease reoperation rates as implant irritation will be minimized,” concluded lead author Sanne Van Cleef, PhD, of the department of mechanical engineering, and colleagues. “This study highlights the unique potential of computer modeling–based approaches in the design process of personalized medical implants.”

Fractures of the clavicle, or collarbone, are common. Unfortunately, current fixation plates that are used to surgically stabilize these fractures are suboptimal, leading to reoperation rates of up to 53%. An important factor for reoperation is plate irritation, caused by poor geometric fit and excessive plate thickness.

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Katholieke Universiteit Leuven