Towards optimization of volar plate fixations of distal radius fractures: Using finite element analyses to reduce the number of screws

BackgroundUsing fewer distal screws in volar plate fixation of radius fractures could reduce treatment costs and complications. However, there is currently no consensus on the ideal screw configuration, likely due to experimental limitations its subject-specific nature. In this study, finite element analysis was used investigate (1) if reducing number biomechanically feasible (2) an optimal configuration subject-specific.MethodsValidated models 16 human radii with extra articular six were as a baseline. 41 additional configurations three simulated for each subject. Axial stiffness peri-implant strains around evaluated. Subject-specific optimum determined using lower bound axial minimizing strains.FindingsEven led only minor deterioration biomechanical properties best (axial stiffness: −11.2%, strains: −35.0%), but considerable worst −46.2%, +112.4%). The optimization showed that average 1.9 be saved based herein criterion.InterpretationThis study highlights not how many, which are critical. Using patient-specific selection bears potential save