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Finite element analysis of dual small plate fixation and single plate fixation for treatment of midshaft clavicle fractures

  • Zhang, Fangxue1
  • Chen, Fancheng2
  • Qi, Yuhan3
  • Qian, Zhi1
  • Ni, Shuo1
  • Zhong, Zeyuan1
  • Zhang, Xu1
  • Li, Dejian1
  • Yu, Baoqing1
  • 1 Fudan University Pudong Medical Center, No.2800 Gongwei Road, Huinan Town, Pudong New Area, Shanghai City, China , Shanghai City (China)
  • 2 Fudan University, Shanghai, China , Shanghai (China)
  • 3 Huazhong University of Science and Technology, Wuhan, People’s Republic of China , Wuhan (China)
Published Article
Journal of Orthopaedic Surgery and Research
Springer (Biomed Central Ltd.)
Publication Date
Apr 15, 2020
DOI: 10.1186/s13018-020-01666-x
Springer Nature


BackgroundMidshaft clavicle fractures are one of the most familiar fractures. And, dual small plate fixation has been reported as can minimize hardware-related complications. However, the biomechanical properties of the dual small plate fixation have not yet been thoroughly evaluated. Here, we report the results of a finite element analysis of the biomechanical properties of midshaft clavicle fractures treated with dual small plating and superior and anteroinferior single plate fixation.MethodsA three-dimensional (3D) finite element model of the midshaft clavicle fractures was created, whose 4-mm transverse fracture gap, having an angle < 30 degree and devoid of overlapping triangles, was simulated between the fractured segments of the middle-shaft of the clavicle. The equivalent von Mises stress and displacement of the model was used as the output measures for analysis.ResultsNo significant differences were found between dual plating, superior or anteroinferior single plating in cantilever bending, axial compression, and axial torsion. Dual plating with a smaller plate-screw construct is biomechanically eligible to compare with superior and anteroinferior single plate fixation using larger plate-screw constructs.ConclusionsThis study demonstrated that larger plate-screw constructs for the treatment of simple are placed clavicular fractures; however, weight-bearing and exorbitant shoulder activity should be avoided after the operation. Therefore, dual plating may provide a viable option for fixing midshaft clavicle fractures and, thus, may be preferred for patients who need early activity.

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