The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

Designing an Anatomical Plate to Improve Biomechanics and Stability for Distal Humerus Fractures: FEM Investigation and the Influence of Meshing Strategy

Document Type : RESEARCH PAPER

Authors
Fahime Rezazade
Azadeh Ghouchani
Department of Biomedical Engineering, Faculty of Engineering, University of Isfahan, Isfahan, Iran
10.22038/abjs.2026.95901.4303
Abstract
Objectives: Distal humerus fractures require stable fixation to restore elbow function, yet conventional plates often exhibit a geometric mismatch with bone morphology, potentially compromising biomechanical performance. Our finite element analysis (FEA) compared a novel anatomical plate designed to conform to native humeral geometry with a conventional plate for treating type B1 distal humerus fractures. The influence of meshing strategy on the outcomes was also evaluated. Both adaptive and uniform approaches were considered.
Methods: A CT-based three-dimensional humerus model with heterogeneous bone properties was reconstructed from scans of a 37-year-old woman. An anatomically contoured plate was compared with a conventional locking plate. Adaptive and uniform meshing were applied separately to each model, and each construct was subsequently tested under 100 N tensile and compressive loads.
Results: The anatomical plate showed higher stiffness (up to 13%), a broader contact pressure distribution (23–28 MPa vs. conventional: 12–18 MPa), and a larger area of sticking contact, whereas the conventional plate produced higher shear stresses (p=0.113). Uniform meshing generated significantly greater interfragmentary motion than adaptive meshing (p=0.008) but caused unrealistically high screw stresses (up to 1526 MPa). Adaptive meshing predicted higher bone stresses, whereas uniform meshing concentrated stresses in the screws. Although meshing affected the absolute stress and strain magnitudes, the comparative differences between plate designs remained consistent.
Conclusion: The anatomically contoured plate offers greater biomechanical stability than conventional designs for distal humerus fractures, as evidenced by reduced displacement and maintained fragment positioning conducive to healing. An adaptive meshing strategy appears more suitable for FEA of complex fixation components because it yields more reliable stress distributions without altering the primary comparative conclusions. Further experimental validation is warranted before clinical application.
Level of evidence: V
Keywords
Anatomical plate design
Bone plates
Distal
Finite element analysis
Fracture fixation
Humeral fractures
Mesh refinement
Subjects
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The Archives of Bone and Joint Surgery
Volume 14, Issue 8
August 2026
Pages 540-549

  • Receive Date 30 May 2026
  • Accept Date 08 June 2026