{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T22:34:24Z","timestamp":1789684464822,"version":"4.0.1"},"reference-count":37,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T00:00:00Z","timestamp":1634601600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004040","name":"KU Leuven","doi-asserted-by":"publisher","award":["BioMeTIOm"],"award-info":[{"award-number":["BioMeTIOm"]}],"id":[{"id":"10.13039\/501100004040","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Current fixation plates used to operatively stabilize clavicular fractures are suboptimal, leading to reoperation rates up to 53%. Plate irritation, which can be caused by a poor geometric fit and plate thickness, has been found to be an important factor for reoperation. Moreover, muscle attachment sites (MAS) have to be detached occasionally. To improve current surgical clavicle fracture treatment with plate osteosynthesis, a change in plate design is required. The goal of this study was to design a patient\u2010specific clavicle fracture fixation plate that includes geometrical optimization and stiffness determination. Its biomechanical performance has been compared with a commercial plate by examining the geometric fit, anatomical outline, stresses and interfragmentary motion using a finite element analysis with physiological loading and boundary conditions. Evaluation showed a better geometrical fit of the patient\u2010specific plate as well as an improved fracture reduction. Displacements between fracture fragments were lower in case of the patient\u2010specific plate, both when a fracture gap and no fracture gap were present. Results indicate a superior mechanical performance in terms of all investigated outcomes of the patient\u2010specific plate compared to the commercial plate, while better aligning with the patient\u2010specific geometry and without the need for MAS release. Due to the patient\u2010specific geometry and reduced thickness, these fixation plates are expected to decrease the operation time, as intraoperative contouring will become irrelevant, and to decrease reoperation rates as implant irritation will be minimized.<\/jats:p>","DOI":"10.1002\/jor.25178","type":"journal-article","created":{"date-parts":[[2021,10,21]],"date-time":"2021-10-21T02:49:37Z","timestamp":1634784577000},"page":"1695-1706","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Thin patient\u2010specific clavicle fracture fixation plates can mechanically outperform commercial plates: An in silico approach"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6068-2793","authenticated-orcid":false,"given":"Sanne","family":"Vancleef","sequence":"first","affiliation":[{"name":"Biomechanics Section, Department of Mechanical Engineering KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariska","family":"Wesseling","sequence":"additional","affiliation":[{"name":"Human Movement Biomechanics Research Group, Department of Movement Sciences KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joost R.","family":"Duflou","sequence":"additional","affiliation":[{"name":"Manufacturing Processes and Systems (MaPS), Department of Mechanical Engineering KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefaan","family":"Nijs","sequence":"additional","affiliation":[{"name":"Department of Development and Regeneration, Locomotor and Neurological Disorders KU Leuven  Leuven Belgium"},{"name":"Department of Traumatology Universitaire Ziekenhuizen (UZ)  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilse","family":"Jonkers","sequence":"additional","affiliation":[{"name":"Human Movement Biomechanics Research Group, Department of Movement Sciences KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos","family":"Vander Sloten","sequence":"additional","affiliation":[{"name":"Biomechanics Section, Department of Mechanical Engineering KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,10,19]]},"reference":[{"issue":"6","key":"e_1_2_8_2_1","first-page":"CD009363","article-title":"Surgical versus conservative interventions for treating fractures of the middle third of the clavicle (Review)","volume":"6","author":"Lenza M","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2018.01.016"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-011-1456-5"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2017.01.040"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2015.10.020"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.G.00111"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.23145"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2018.09.018"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.23533"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-52845-8"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-1383(97)90109-1"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2016.06.004"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.medengphy.2016.06.021"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e3182143e06"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2004.05.022"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/10255842.2016.1181174"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2008.01.014"},{"key":"e_1_2_8_19_1","first-page":"1774","volume-title":"J. 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