Biomechanical study of Tibial plateau fractures using 3D printing and digital design: A finite element analysis.

BACKGROUND

Tibial plateau fractures are common traumatic orthopedic conditions typically requiring open surgical repair. This study aimed to evaluate the biomechanical performance of digitally designed fixation systems for tibial plateau fractures using 3D printing-assisted modeling and finite element analysis, providing theoretical support for individualized surgical planning and fixation optimization.

METHODS

Three finite element analysis models of the tibia were established based on the displacement of bone fragments and the stresses on internal fixation plates and screws when the steel plate was positioned at different locations. These models represent: a multi-option comparison of internal fixation systems for tibial plateau fractures; a preoperative planning approach based on stress and displacement evaluation; and a patient-specific internal fixation plan for tibial plateau fractures. The study analyzed von Mises stress distribution and range of motion data.

FINDINGS: The repair methods are ranked in descending order based on maximum von Mises stress: Preoperative planning based on stress and displacement assessment > Patient-specific tibial plateau fracture internal fixation > Comparison of multiple tibial plateau fracture-internal fixation systems. When comparing repair methods in descending order of fracture fragment displacement, the patient-specific tibial plateau fracture internal fixation approach is optimal. The group utilizing 3D printing technology demonstrated superior intraoperative metrics compared to the conventional surgery group (P < 0.05). Furthermore, the 3D-printed group achieved superior scores in knee function assessments.

INTERPRETATION: Compared to traditional repair techniques, 3D printing combined with digital design offers biomechanical advantages such as more uniform stress distribution, lower peak stress, and superior stability, making it a viable alternative for tibial plateau fracture surgery.