Establishment Of A Three-Dimensional Finite Element Model And Biomechanical Analysis Of Three Different Internal Fixation Methods For Humeral Greater Tuberosity Fracture

Objective: The aim of this study was to provide the basis for implanting selection by comparing the biomechanical performances of three fixation techniques used in the treatment of greater tuberosity fracture: screws, a tension band, or the locking plate which were specifically designed through the establishment of a three-dimensional finite element model. Methods: Three-dimensional reconstructions of the scapula and proximal humerus were assembled and a finite element model was established. Loading force and traction testing was carried out using the maximal contraction force of the rotator cuff muscle. The maximum displacement, maximum Von Mises stress, and the displacement and stress distribution diagram of the three fixation models were compared. Results: The stress applied to the greater tuberosity of the locking plate and screw was lower than the yield strength of titanium alloy. The greater tuberosity locking plate demonstrated homogeneous stress distribution, and the stress was dispersed and transmitted rapidly, closer to the physiological state. The biomechanical stability was also greater than that of the screw fixation or tension band fixation. Conclusion: The locking plate demonstrated significant biomechanical advantages of stress dispersion and transmission compared to screw or tension band fixation in the treatment of greater tuberosity fracture.