Effects of CFR-PEEK plate layup and screw configuration on tibial shaft fracture healing: a simulation study based on a mechanobiological model.

Based on the biphasic mechanoregulation theory, this study developed a mechanobiological model integrates biomechanical stimulus calculation, cellular behaviors, and dynamic updating of callus tissue modulus, to simulate the healing process of tibial shaft fractures stabilized with CFR-PEEK bone plates. The effects of three layup schemes and five screw configurations were evaluated. The model predictions indicate that the combination of the [±45]4S layup with the flexible C5 screw configuration provides appropriate mechanical stimulation during the mid-to-late healing phase, effectively promotes endochondral ossification, and yields the most favorable simulated healing outcome.