Advantage of Multi-Directional Stability of Spiral Clavicle Plate in Treatment of Middle One-Third Clavicle Fracture: A Finite Element Study

Purpose A high prevalence of middle one-third clavicle fracture has been reported. Both superior and anterior clavicle plates have been used in clinical and biomechanical research, but no decisive advantage for either design has been reported. Spiral clavicle plates have not been well studied in terms of their structural stability and implant safety. The present study analyses the multi-directional biomechanical performance of spiral clavicle plates using the finite element method. Methods Two commercial spiral clavicle plate designs were reconstructed to simulate the surgical reduction of a middle one-third oblique clavicle fracture (OTA classification: 15-B1.2). Mechanical load, including axial compression, inferior bending, and axial torsion, was applied to evaluate the multi-directional structural stability and implant safety of the plates. Results The two spiral clavicle plate designs enhanced structural stiffness under axial compression, inferior bending, and axial torsion by 59–71%, 38–82%, and 31–46%, respectively, compared to that of the intact clavicle model. Stress concentrations were found around the reconstruction feature of the plate and the screw hole, especially under inferior bending. Conclusion The improvement in multi-directional biomechanical stability provided by a spiral clavicle plate is worth considering in clinical applications. Implant safety should be further investigated based on mechanical tests and clinical observations.