Finite element analysis of T-Plate and customized Y-Plate in the treatment of medial tibial plateau fractures
REN Xiao-meng
DU Long-bo
MA Rui
JIANG Yu
LI Meng
GAO Yi
LI Jian-tao
ZHANG Wei
Abstract：Objective To compare the biomechanical behavior of customized medial Y-plate with conventional T-plate in the treatment of different Wahlquist subtypes of medial tibial plateau fractures.Methods CT scan data from a healthy adult female knee were used to recreate the tibia's geometry and model a medial tibial plateau fracture according to the Wahlquist classification.The fracture was categorized into three subtypes:type A with sagittal fracture lines positioned in the medial intercondylar region,type B with sagittal fracture lines passing through the intercondylar crest,and type C with sagittal fracture lines situated laterally to the intercondylar crest.Each subtype was fixed using either a customized Y-shaped plate or a conventional T-shaped plate.Finite element analysis was conducted via Ansys 2021 software to generate stress and displacement outputs for all nodes within each component utilizing both fixation methods.The data were then analyzed statistically using the Mann-Whitney nonparametric test.Results The maximum stress location for the three fracture types A,B,and C was at the distal nail hole,regardless of T-or Y-plate fixation.The bone stress in the Y-plate fixation group was significantly higher than that in the T-plate group(P<0.0001);and the displacement of the medial fracture fragment in the medial-lateral direction in the Y-plate group was significantly higher than that in the T-plate group(P<0.0001);The Y-plate group showed a significantly higher medial-lateral displacement of the medial fracture fragment compared to the T-plate group(P<0.0001),whereas significantly lower displacement than the T-plate group in the anteroposterior and superior-inferior directions(P<0.0001).Conclusions In treating various types of medial tibial plateau fractures in Wahlquist,customized medial Y-plates have been found to significantly reduce the stress-shielding effect when compared to T-plates.Furthermore,Y-plates provide greater resistance to axial and anteroposterior sliding of the medial fracture fragment,as well as better overall mechanical performance.
Keywords：Tibial fracturesBone platesBiomechanical phenomenaFinite element analysis
Publication Date：2024-06-19
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 436-443 )