Analyses of eight internal fixation techniques of a fracture of the distal humerus by nonlinear FEM- Simulation, evaluating the generalized force deflection behavior in comparison to an intact bone

A study of eight different internal fixation techniques of a fracture of the distal humerus is presented with four configurations of double or 3-plate osteosynthesis, using conventional 3.5mm and locked 3.5-mm reconstruction plates. Dorsal (groups 1 and 3), 90° (groups 2 and 4), sagittal (groups 5 and 7) and 3-plate (groups 6 and 8) configurations were studied for elastomechanical properties of the constructs. A realistic bone representation was obtained by mapping the clinically measured CT-density distribution onto an inhomogeneous stiffness representation. Simplified loading situations of four generalized forces ( tension and moments ) were analyzed and the respective stiffnesses of the stabilized bone were compared to the stiffness of an intact bone. The applied modelization technique of the manual adaptation of plates to the outer surface of the bone, performed with the ANSA-morphing tool, is also presented.