Design of a novel lateral mass screw–plate system for the treatment of unstable atlas fractures: a finite element analysis
Abstract Background Osteosynthesis of unstable atlas fractures preserves joint motion and therefore has a distinct advantage over a range of treatment procedures. To prevent the potential disadvantages associated with osteosynthesis, a new atlas lateral mass screw–plate (LMSP) system has been design...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-024-04582-6 |
| _version_ | 1827326749163126784 |
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| author | He-Gang Niu Jing-Jing Zhang Yi-Zhu Yan Cheng-Kun Zhao Kun Yang Yin-Shun Zhang |
| author_facet | He-Gang Niu Jing-Jing Zhang Yi-Zhu Yan Cheng-Kun Zhao Kun Yang Yin-Shun Zhang |
| author_sort | He-Gang Niu |
| collection | DOAJ |
| description | Abstract Background Osteosynthesis of unstable atlas fractures preserves joint motion and therefore has a distinct advantage over a range of treatment procedures. To prevent the potential disadvantages associated with osteosynthesis, a new atlas lateral mass screw–plate (LMSP) system has been designed. However, the biomechanical role of using the LMSP system in atlas internal fixation is not known. The aim of this study was to compare the biomechanical stability of a new LMSP with traditional posterior screw and rod (PSR) fixation techniques on the occipitocervical junction (C0–C2) through finite element analysis. Methods A nonlinear C0–C2 finite element model of the intact upper cervical spine was developed and validated. The unstable model using the PSR system was then compared with the model using the LMSP system for fixation. A vertical load of 40 N was applied to the C0 to simulate head weight, while a torque of 1.5 Nm was applied to the C0 to simulate flexion, extension, lateral bending, and axial rotation. Results The range of motion of both systems was close to the intact model. Compared with the LMSP system model, the PSR system model increased flexion, extension, lateral bending, and axial rotation by 4.9%, 3.0%, 5.0%, and 29.5% in the C0–C1 segments, and 4.9%, 2.7%, 2.4%, and 22.6% in the C1–C2, respectively. In flexion, extension, and lateral bending motion, the LMSP system model exhibited similar stress to the PSR system model, while in axial rotation, the PSR system model exhibited higher stress. Conclusions The findings of our study indicate that the two tested system models provide comparable stability. However, better stability was achieved during axial rotation with the LMSP system, and in this system, the maximum von Mises stress was less than that of the PSR one. As the atlantoaxial joint functions primarily as a rotational joint, the use of the LMSP system may provide a more stable environment for the joint that has become unstable due to fracture. |
| first_indexed | 2024-03-07T14:49:59Z |
| format | Article |
| id | doaj.art-dafc104a7b5a4016926e3f197eceeafd |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-03-07T14:49:59Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-dafc104a7b5a4016926e3f197eceeafd2024-03-05T19:45:48ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2024-02-0119111010.1186/s13018-024-04582-6Design of a novel lateral mass screw–plate system for the treatment of unstable atlas fractures: a finite element analysisHe-Gang Niu0Jing-Jing Zhang1Yi-Zhu Yan2Cheng-Kun Zhao3Kun Yang4Yin-Shun Zhang5Department of Orthopedics, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Orthopedics, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Orthopedics, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Orthopedics, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Orthopedics, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Orthopedics, The First Affiliated Hospital of Anhui Medical UniversityAbstract Background Osteosynthesis of unstable atlas fractures preserves joint motion and therefore has a distinct advantage over a range of treatment procedures. To prevent the potential disadvantages associated with osteosynthesis, a new atlas lateral mass screw–plate (LMSP) system has been designed. However, the biomechanical role of using the LMSP system in atlas internal fixation is not known. The aim of this study was to compare the biomechanical stability of a new LMSP with traditional posterior screw and rod (PSR) fixation techniques on the occipitocervical junction (C0–C2) through finite element analysis. Methods A nonlinear C0–C2 finite element model of the intact upper cervical spine was developed and validated. The unstable model using the PSR system was then compared with the model using the LMSP system for fixation. A vertical load of 40 N was applied to the C0 to simulate head weight, while a torque of 1.5 Nm was applied to the C0 to simulate flexion, extension, lateral bending, and axial rotation. Results The range of motion of both systems was close to the intact model. Compared with the LMSP system model, the PSR system model increased flexion, extension, lateral bending, and axial rotation by 4.9%, 3.0%, 5.0%, and 29.5% in the C0–C1 segments, and 4.9%, 2.7%, 2.4%, and 22.6% in the C1–C2, respectively. In flexion, extension, and lateral bending motion, the LMSP system model exhibited similar stress to the PSR system model, while in axial rotation, the PSR system model exhibited higher stress. Conclusions The findings of our study indicate that the two tested system models provide comparable stability. However, better stability was achieved during axial rotation with the LMSP system, and in this system, the maximum von Mises stress was less than that of the PSR one. As the atlantoaxial joint functions primarily as a rotational joint, the use of the LMSP system may provide a more stable environment for the joint that has become unstable due to fracture.https://doi.org/10.1186/s13018-024-04582-6Atlas fracturesOpen reduction and internal fixation (ORIF)Cervical spineBiomechanicsFinite element analysis |
| spellingShingle | He-Gang Niu Jing-Jing Zhang Yi-Zhu Yan Cheng-Kun Zhao Kun Yang Yin-Shun Zhang Design of a novel lateral mass screw–plate system for the treatment of unstable atlas fractures: a finite element analysis Journal of Orthopaedic Surgery and Research Atlas fractures Open reduction and internal fixation (ORIF) Cervical spine Biomechanics Finite element analysis |
| title | Design of a novel lateral mass screw–plate system for the treatment of unstable atlas fractures: a finite element analysis |
| title_full | Design of a novel lateral mass screw–plate system for the treatment of unstable atlas fractures: a finite element analysis |
| title_fullStr | Design of a novel lateral mass screw–plate system for the treatment of unstable atlas fractures: a finite element analysis |
| title_full_unstemmed | Design of a novel lateral mass screw–plate system for the treatment of unstable atlas fractures: a finite element analysis |
| title_short | Design of a novel lateral mass screw–plate system for the treatment of unstable atlas fractures: a finite element analysis |
| title_sort | design of a novel lateral mass screw plate system for the treatment of unstable atlas fractures a finite element analysis |
| topic | Atlas fractures Open reduction and internal fixation (ORIF) Cervical spine Biomechanics Finite element analysis |
| url | https://doi.org/10.1186/s13018-024-04582-6 |
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