Optimal configuration of a dual locking plate for femoral allograft or recycled autograft bone fixation: A finite element and biomechanical analysis

Allografts and recycled bone autograft are commonly used for biological reconstruction. The dual locking plates fixation method has been advocated for increasing allograft stability and preventing fixation failure; however, the biomechanical properties of the various configurations of dual locking plates have not been extensively studied. In a finite element (FE) analysis, we developed 6 patterns of different dual locking plate configurations for fixation of the mid shaft of the femur. The maximum strains were recorded for each of the 6 models then axial, bending and torsion stiffness were calculated. The FE analysis was validated the results with mechanical testing (axial compression, bending, and torsional stiffness) on a cadaveric femur. The highest axial compression (715.41 N/mm) and lateral bending (2981.24 N/mm) was found in Model 4 (with two 10-hole locking plates placed at the medial and lateral side), while the highest torsional stiffness (193.59 N·mm /mm) was found in Model 3 (with 8- and 10-hole locking plates placed at the posterior and lateral side). Excellent agreement was found between the finite element analysis and biomechanical testing (r2 = 0.98). The dual locking plate configuration with medial and lateral, 10-hole locking plates provided the most rigid and strongest fixation of the femur; both in terms of axial compression and lateral bending stiffness. •Dual locking plates fixation method improve allograft stability and prevent fixation failure•The highest axial compression was found in the medial and lateral 10-hole locking plates•The highest lateral bending stiffness was found in the medial and lateral 10-hole locking plates•Excellent agreement was found between the finite element analysis and biomechanical testing•The medial and lateral 10-hole locking plates provides the most rigid fixation of the femur