{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:11:02Z","timestamp":1786705862522,"version":"build-2736575974"},"reference-count":52,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,9,15]],"date-time":"2024-09-15T00:00:00Z","timestamp":1726358400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Axial micromotion between bone fragments can stimulate callus formation and fracture healing. In this study, we propose a novel mechanically compliant locking plate which achieves up to 0.6\u2009mm of interfragmentary motion as flexures machined into the plate elastically deflect under physiological load. We investigated the biomechanical performance of three compliant plate variations in comparison to rigid control plates with small and large working lengths in a comminuted bridge plating scenario using humeral diaphysis surrogates. Under static axial loading, average interfragmentary motion was 6 times larger at 100\u2009N (0.38 vs. 0.05\u2009mm) and nearly three times larger at 350\u2009N (0.58 vs. 0.2\u2009mm) for compliant plates than rigid plates, respectively. Compliant plates delivered between 2.5 and 3.4 times more symmetric interfragmentary motion than rigid plates (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). The bi\u2010phasic stiffness of compliant pates provided 74%\u201396% lower initial axial stiffness up to approximately 100\u2009N (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), after which compliant plate stiffness was similar to rigid plates with increased working length (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.3). The strength to failure of compliant plates under dynamic loading was on average 48%\u201355% lower than rigid plate groups (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01); however, all plates survived cyclic fatigue loading of 100,000 cycles at 350\u2009N. This work characterizes the improvement in interfragmentary motion and the reduction in strength to failure of compliant plates compared to control rigid plates. Compliant plates may offer potential in comminuted fracture healing due to their ability to deliver symmetric interfragmentary motion into the range known to stimulate callus formation while surviving moderate fatigue loading with no signs of failure.<\/jats:p>","DOI":"10.1002\/jor.25968","type":"journal-article","created":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T03:40:19Z","timestamp":1726458019000},"page":"217-227","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Mechanically compliant locking plates for diaphyseal fracture fixation: A biomechanical study"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4526-2771","authenticated-orcid":false,"given":"Connor","family":"Huxman","sequence":"first","affiliation":[{"name":"Department of Mechanical Engineering The Pennsylvania State University University Park Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3673-0182","authenticated-orcid":false,"given":"Gregory","family":"Lewis","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation Penn State Milton S. Hershey Medical Center Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3729-9811","authenticated-orcid":false,"given":"April","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation Penn State Milton S. Hershey Medical Center Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1594-7411","authenticated-orcid":false,"given":"Gary","family":"Updegrove","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation Penn State Milton S. Hershey Medical Center Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7645-8179","authenticated-orcid":false,"given":"Zachary","family":"Koroneos","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation Penn State Milton S. Hershey Medical Center Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3526-9678","authenticated-orcid":false,"given":"Jared","family":"Butler","sequence":"additional","affiliation":[{"name":"School of Engineering Design and Innovation The Pennsylvania State University University Park Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,15]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph15122845"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2019.04.995"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/17434440.2020.1779055"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000131484.27501.4b"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.1100010412"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2018.04.031"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.I.01111"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-1383(18)30309-7"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200910000-00007"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01654345"},{"issue":"3","key":"e_1_2_7_12_1","first-page":"228","article-title":"Biomechanics of fracture healing","volume":"23","author":"Perren SM","year":"1980","journal-title":"Can J Surg"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.67B4.4030869"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.73B4.2071654"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0268-0033(95)99799-8"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0736-0266(02)00044-X"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-003-0396-0"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e318207093e"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0736-0266(03)00098-6"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.1100160413"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0268-0033(98)00097-7"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2021.110576"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2008.11.002"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.O.00705"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e3181be6720"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-011-1870-6"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2010.11.020"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2015.02.006"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.O.00684"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.25583"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00776-005-0984-7"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199706000-00032"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-010-0636-z"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.22881"},{"key":"e_1_2_7_35_1","first-page":"1","article-title":"Dynamic fixation of humeral shaft fractures using active locking plates: a prospective observational study","volume":"37","author":"Madey SM","year":"2017","journal-title":"Iowa Orthop J"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.3389\/fbioe.2020.593448"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2020.110192"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2020.04.032"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1302\/2633-1462.210.BJO-2021-0121.R1"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1115\/1.4052011"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1115\/1.4063967"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1115\/1.4056381"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.25446"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e3181c29bf5"},{"issue":"2","key":"e_1_2_7_45_1","article-title":"Immediate weight bearing after fixation of humeral shaft fractures with small fragment hybrid plating: a biomechanical analysis","volume":"2","author":"Bledsoe JG","year":"2021","journal-title":"J Orthop Exp Innov"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-200109000-00004"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000001776"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1038\/nmeth.2089"},{"issue":"138","key":"e_1_2_7_49_1","first-page":"175","article-title":"Physical and biological aspects of fracture healing with special reference to internal fixation","author":"Perren SM","year":"1979","journal-title":"Clin Orthop Relat Res"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1115\/DMD2023-8517"},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e3181df968c"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.00780"},{"key":"e_1_2_7_53_1","doi-asserted-by":"publisher","DOI":"10.1302\/2046-3758.71.BJR-2017-0074.R2"}],"container-title":["Journal of Orthopaedic Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jor.25968","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T06:59:58Z","timestamp":1733295598000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jor.25968"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,15]]},"references-count":52,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1002\/jor.25968"],"URL":"https:\/\/doi.org\/10.1002\/jor.25968","archive":["Portico"],"relation":{},"ISSN":["0736-0266","1554-527X"],"issn-type":[{"value":"0736-0266","type":"print"},{"value":"1554-527X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,15]]},"assertion":[{"value":"2024-06-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}