Evaluation of internal fixation techniques for condylar head fractures: A finite element analysis and comparison

Lingtong Bu; Qin Chen; Kai Huang; Xiaowen Zhao; Jisi Zheng; Yating Qiu; Chi Yang

doi:10.1016/j.oooo.2021.08.028

Evaluation of internal fixation techniques for condylar head fractures: A finite element analysis and comparison

Oral Surg Oral Med Oral Pathol Oral Radiol. 2022 May;133(5):e96-e104. doi: 10.1016/j.oooo.2021.08.028. Epub 2021 Sep 5.

Authors

Lingtong Bu¹, Qin Chen², Kai Huang³, Xiaowen Zhao³, Jisi Zheng⁴, Yating Qiu⁵, Chi Yang⁶

Affiliations

¹ Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China. Electronic address: bulingtong97@163.com.
² Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China.
³ Shenzhen Excellent Technology Company Limited, Shenzhen, Guangdong, China.
⁴ Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China. Electronic address: 237111641@qq.com.
⁵ Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China. Electronic address: qiuyating@hotmail.com.
⁶ Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China. Electronic address: yang_chi63@163.com.

PMID: 34716116
DOI: 10.1016/j.oooo.2021.08.028

Abstract

Objectives: This study evaluated optimum stability of different screw techniques for condylar head fractures (CHF) (P close to an M fracture with the lateral pole preserved according to AO classification 2014) by finite element analysis (FEA) and provided a biomechanical basis for clinical treatment.

Study design: Four CHF fixation models were evaluated: (A) single bicortical screw, (B) 2 bicortical screws, (C) 1 bicortical screw and 1 monocortical screw (used as a positional screw) inserted via a 2-hole titanium plate, and (D) 2 bicortical screws inserted via a titanium plate. Stresses were calculated (FEA) to measure mechanical properties.

Results: The displacement for A and C was larger than for B and D. The maximum stress on the screws for A and C exceeded their breaking limit but was safe for B and D. The stress on the titanium plate for C and D was safe. The stress on bone for A and C was larger than for B and D.

Conclusions: The 2 bicortical screw fixation reduced the stress on implanted materials and surrounding bone tissue. Titanium plates further alleviated the lever action. Two bicortical screw fixation was more reliable for CHF, and early postoperative loading and functional training can be expected.

MeSH terms

Biomechanical Phenomena
Bone Plates
Bone and Bones
Finite Element Analysis
Fracture Fixation, Internal*
Humans
Titanium*

Substances

Titanium