Assessment of Fixation Stability in Tibial Fractures Osteosynthesized with Plates and Screws During the Resumption of Walking
摘要
Tibia fractures are a significant focus in biomechanics research. This study specifically examines the use of plate and screw osteosynthesis for treating tibia fractures. Understanding and evaluating post-operative recovery, particularly the time required for patients to stand or resume walking, is crucial in this area. The 3D finite element method, employing an elastoplastic behavior law coupled with damage based on experimental testing on synthetic bone, is considered in this study. This method is used to simulate the insertion process of self-tapping screws for reduction fractured bone fragments. Thread formation occurred through material removal when the induced stresses exceeded a critical deformation level. Maintaining a standing position for the first four weeks resulted in widening of the drill holes. During this period, load transfer occurred through the plate directly connected to the screws. Between the fourth and twelfth weeks, standing led to permanent deformations at the callus formation gap. Prolonging weight-bearing for three times longer caused even more pronounced de-formations, doubling the initial effect, which is detrimental to proper weight-bearing recovery. Simulating walking resumption by applying five successive steps kept maximum deformations within the bone’s elastic limit at the callus throughout the loading period. Notably, at 16 weeks, the maximum deformations are approximately ten times less than those observed at four weeks, in both the cortical and cancellous regions. This finding highlights significant progress in the recovery process over time and indicates that applying gradual and intermittent pressure is unlikely to cause permanent deformations at the callus.