ArticleJournal of orthopaedic surgery and research2023
Biomechanical comparison of different screw-included angles in crossing screw fixation for transverse patellar fracture in level walking: a quasi-dynamic finite element study.
Article in Journal of orthopaedic surgery and research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Individualized multimodal integration of optimized dual fluoroscopic imaging registration and finite element modeling for knee joint stress during stair ascent.Medical & biological engineering & computing · 2026Article
- Tension-band high-strength suture combined with absorbable screws with cortical penetration for treating Mayo type IIA olecranon fractures: finite element analysis, biomechanical testing, and clinical study.Frontiers in bioengineering and biotechnology · 2026Article
- [Patellar fractures : Modern treatment concepts in clinical routine practice].Unfallchirurgie (Heidelberg, Germany) · 2026Review
- Comparative clinical outcomes of dual cannulated screw-cable system vs. Kirschner wire-cable fixation in type C patellar fractures.Frontiers in surgery · 2025Article
- Advanced topology of triply periodic minimal surface structure for osteogenic improvement within orthopedic metallic screw.Materials today. Bio · 2024Article
- Tension band high-strength suture combined with absorbable cannulated screws for treating transverse patellar fractures: finite element analysis and clinical study.Frontiers in bioengineering and biotechnology · 2024Article
- A novel patella fracture fixation technique: finite element analysis.Archives of orthopaedic and trauma surgery · 2023Article
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Authors and funding
4 authors.
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Abstract
backgroundA minimally invasive technique with various screw configurations without open surgery is currently used for the fixation of transverse patellar fractures. Percutaneous crossing screw configuration has been reported to have a good bone union rate in patellar fractures. However, the difference in mechanical stability of the fractured patella between different screw-included angles has not been fully investigated. Hence, this study aims to compare the mechanical stability of parallel and crossing screw fixations with different screw-included angles for the fixation of transverse patellar fractures during level walking.
methodsA finite element knee model containing a patella with a transverse fracture is created. Two headless compression screws with different angles (0°, 30°, 60°, and 90°) are used to fix the fracture. The loading conditions of the knee joint during level walking are used to compare the stability of the fractured patella with different fixation screw configurations.
resultsThe results indicate that the maximum fracture gap opening distance increased with an increase in the included angle. Two parallel screws yield the smallest gap distance among all screw configurations. The maximum gap opening distances at the anterior leading edge of the fractured patella with two parallel screws and two screws having an included angle of 90° are 0.73 mm and 1.31 mm, respectively, at 15% walking cycle.
conclusionsBased on these results, the superior performance of two parallel screws over crossing screw fixations in the fixation of transverse patellar fractures is established. Furthermore, the smaller the angle between the crossing screws, the better is the stability of the fractured patella.
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