Patient-Specific Tibial Plateau Plates for Stable Fracture Fixation
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Solution Overview
Problem
Traditional internal fixation systems for tibial plateau fractures, particularly Schatzker type V and type VI fractures, are inadequate in providing stable fixation, often requiring multiple plates, leading to soft tissue irritation, necrosis, and poor fracture alignment, with no effective system for posterolateral plateau fractures.
Innovation Solution
A design method for anatomical plates involving high-precision three-dimensional modeling, adjusting plate thicknesses based on patient-specific soft tissue and body weight, and customizing plate shapes and screw hole positions to match the patient's anatomy, using CAD software for simulation and biomechanical analysis.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If traditional internal fixation systems (plate and screw) are used for tibial plateau fractures, then fixation can be provided, but stable internal fixation cannot be achieved and multiple plates (3-4 plates) are required
Solution Approach 1:
The traditional single plate design is segmented into a proximal plate body and a distal plate body that are connected via a hinge structure. This segmentation allows each plate segment to independently adapt to different anatomical regions of the tibial plateau, providing stable fixation without requiring multiple separate plates. The hinge connection enables relative movement between segments to accommodate fracture displacement while maintaining overall fixation stability.
Solution Approach 2:
The hinge connection between the proximal and distal plate bodies introduces dynamic capability to the fixation system. The hinge allows rotational movement that accommodates the natural displacement and angulation of fracture fragments during healing, while still maintaining stable fixation. This dynamic adaptation eliminates the need for additional static plates to compensate for rigidity limitations.
2Reliability
If multiple plates are used for fixation, then coverage can be improved, but soft tissue tension increases and irritation is serious leading to necrosis and amputation
Solution Approach 1:
Multiple separate plates are merged into a single integrated flexible fixation device consisting of connected plate bodies. This unified structure provides comprehensive coverage of the fracture site while eliminating the cumulative soft tissue irritation caused by multiple separate implants. The integrated design reduces the total number of implant-bone interfaces and soft tissue disruptions, thereby reducing the risk of necrosis and amputation.
Solution Approach 2:
The fixation device incorporates variable thickness design where the plate thickness changes along its length to optimize both coverage and soft tissue compatibility. Thinner sections are positioned in areas with limited soft tissue coverage to minimize irritation and necrosis risk, while thicker sections provide adequate coverage and stability in areas with sufficient soft tissue envelope. This parameter optimization allows single-plate fixation with improved soft tissue outcomes.
3Reliability
If traditional plates are used for posterolateral plateau fracture, then fixation can be attempted, but no effective internal fixation system exists and additional plates are needed
Solution Approach 1:
The flexible fixation device incorporates locally optimized plate bodies with specific geometries designed for posterolateral plateau fracture patterns. The proximal and distal plate bodies can be configured with different widths, thicknesses, and screw hole distributions tailored to the specific fracture location and pattern. This local customization enables effective single-plate fixation for posterolateral fractures without requiring additional auxiliary plates.
4Reliability
If traditional plates are used, then fixation can be provided, but fit is not good enough and fracture alignment cannot be maintained
Solution Approach 1:
The flexible fixation device incorporates pre-configured plate geometries and hinge configurations that are predetermined to match common tibial plateau fracture patterns. The plate bodies are designed with pre-calculated thickness distributions and screw hole positions that facilitate proper fracture reduction and alignment. This preliminary design optimization ensures good fit and alignment maintenance without requiring complex intraoperative customization or multiple trial plates.
Data Source
AI summary
A design method of an anatomical plate for treating a tibial plateau fracture and an internal fixation device are provided. The design method includes: obtaining a high-precision three-dimensional model of a fractured bone of a patient; obtaining a post-reduction bone model; extracting point arrays of a cross section and a sagittal plane and obtaining solid body designs of a lateral plate body and a medial plate body; and adjusting thicknesses of proximal ends of the lateral plate body and the medial plate body, adjusting thicknesses of main bodies of the lateral plate body and the medial plate body, cutting the lateral plate body and the medial plate body from a sagittal plane according to a fit condition of the lateral plate body and the medial plate body, and determining a position and a direction of a screw hole to obtain a lateral anatomical plate and a medial anatomical plate.