Effect of contralateral cortical locking plate length on biomechanics of internal fixation for distal femur fractures

doi:10.12307/2026.544

Abstract

Abstract: BACKGROUND: Contralateral cortical locking technique has achieved good clinical outcome in the treatment of distal femur fractures in clinical practice, but the influence of the choice of contralateral cortical locking plate length on biomechanics of internal fixation for distal femur fractures has not been clarified. Thus, the clinical guidance for contralateral cortical locking application remains unavailable.
OBJECTIVE: To explore the effect of different contralateral cortical locking plate lengths on the biomechanics of internal fixation of distal femur fractures.
METHODS: CT image data of the 4th generation synthetic Sawbones femur model were used to create a digital model of the comminuted fracture defect of a distal femur (AO-A3) using three-dimensional reconstruction techniques. On this basis, three different lengths of contralateral cortical locking steel plates with 14, 16, and 18 holes were simulated. Finite element analysis was performed by applying equal axial compression loads to the three sets of internal fixation models to compare the stiffness, the magnitude of displacement change at the fracture end, and the maximum equivalent stress among different models.
RESULTS AND CONCLUSION: (1) For different lengths of contralateral cortical locking plates, the 16-hole plate model had the lowest axial stiffness, the highest displacement at the fracture, and the peak equivalent stress was located at the proximal P4 screw, with values that were 7.47% and 1.80% higher compared to the 14-hole and 18-hole screws with the highest stress, respectively. (2) Comparing the plate stresses of the three models, the 16-hole plate had the smallest peak stress and the highest stress was located at the first nail hole proximal to the plate. (3) The stability of contralateral cortical locking plate fixation for distal femur fractures did not improve with the increase in length. The appropriate plate length should be selected following the principles of patient individualization and trauma control in clinical practice.

Key words: contralateral cortical locking, femur fracture, internal fixation, biomechanics, finite element analysis, orthopedic implant

CLC Number:

Ouyang Hanbin, Lin Kewei, Zhang Xin, Zhang Ziwei, Feng Bolin, Zhong Huan, Huang Huajun. Effect of contralateral cortical locking plate length on biomechanics of internal fixation for distal femur fractures[J]. Chinese Journal of Tissue Engineering Research, 2026, 30(15): 3832-3838.

Figures/Tables 2

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