Influence of the Screw Positioning on the Stability of Locking Plate for Proximal Tibial Fractures: A Numerical Approach

Tibial fractures are common injuries in people. The proper treatment of these fractures is important in order to recover complete mobility. The aim of this work was to investigate if screw positioning in plates for proximal tibial fractures can affect the stability of the system, and if it can consequently influence the patient healing time. In fact, a more stable construct could allow the reduction of the non-weight-bearing period and consequently speed up the healing process. For that purpose, virtual models of fractured bone/plate assemblies were created, and numerical simulations were performed to evaluate the reaction forces and the maximum value of the contact pressure at the screw/bone interface. A Schatzker type I tibial fracture was considered, and four different screw configurations were investigated. The obtained results demonstrated that, for this specific case study, screw orientation affected the pressure distribution at the screw/bone interface. The proposed approach could be used effectively to investigate different fracture types in order to give orthopaedists useful guidelines for the treatment of proximal tibial fractures.