Finite element analysis of application of variable angle screws in posterolateral tibial plateau fractures

doi:10.12307/2025.823

Abstract

Abstract: BACKGROUND: During the treatment of posterolateral tibial plateau fractures through the fibular head approach, the gap between the fibular head and the lateral plateau cannot accommodate the posterior placement of a plate for all patients.
OBJECTIVE: To analyze, via finite element analysis, the differences in fixation strength resulting from varying the angles and quantities of horizontal arm variable angle screws in the plate during the treatment of posterolateral tibial plateau fractures through the fibular head approach.
METHODS: A finite element model was established based on CT images of the knee to ankle joints of a 30-year-old healthy adult male volunteer. The models were divided into two categories: posteriorly placed group and non-posteriorly placed group based on whether the lateral locking compression plate was posteriorly placed. The posteriorly placed group was further subdivided into groups A-D based on the offset angle of the two variable angle screws (0°, 5°, 10°, and 15°). The non-posteriorly placed group was subdivided into groups E and F based on offset angles (0° and 15°). Finite element analysis was used to evaluate the von Mises stress distribution, maximum von Mises stress, and compressive displacement under loads of 250, 500, and 750 N, exploring the mechanical differences between the groups.
RESULTS AND CONCLUSION: (1) Finite element analysis results showed that under a 750 N load, the maximum compressive displacement trend of the internal fixation device was D < B=C=F < A < E. The trend for maximum von Mises stress was B < C < A < D < F < E. The trend for maximum compressive displacement on the bone was C=D < B < A < F < E, and for maximum von Mises stress, it was B < C < A < F < D < E. The displacement and stress trends for the six models were similar under loads ranging from 250 N to 750 N. (2) These results suggest that for posterolateral tibial plateau fractures fixed through the fibular head approach, posterior placement of the plate should aim to accommodate two screws. If only one screw can be fixed during surgery, variable angle screws should be offset in the range of 0-15° to increase the probability of securing two screws.

Key words: posterolateral tibial plateau fracture, fibular head approach, finite element analysis, variable angle screw, plate posterior placement, knee joint, stress dispersion, biomechanics

CLC Number:

R459.9|R318|R687.4

Hu Zhenghui, Zhang Wen, Heng Hongquan, Ren Weizhi, Wu Chenying, Gu Zenghui, Peng Jian, Li Liubing, Xu Wei. Finite element analysis of application of variable angle screws in posterolateral tibial plateau fractures[J]. Chinese Journal of Tissue Engineering Research, 2025, 29(27): 5735-5742.

Figures/Tables 6

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