{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T07:28:33Z","timestamp":1748244513138,"version":"3.40.5"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T00:00:00Z","timestamp":1667952000000},"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":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Implant failure is a disastrous complication of the operative treatment of midshaft clavicle fractures, and improving the osteosynthesis plate is a strategy for preventing this. We aimed to investigate whether canceling the notch and adding screw\u2010hole inserts enhanced the mechanical properties of the plate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A clavicle model was generated based on the CT images of six adult volunteers (age range, 20\u201340\u2009years; three males and three females; height range 160\u2013175) using dedicated software, and a midshaft fracture model was created. The domestically made seven\u2010hole locking plate commonly used for midshaft clavicle fractures was simulated (Model I); modifications were made to the plate (Model II). Using 3D finite element analysis, we simulated the fracture construct under three different load conditions\u2014downward cantilever bending, axial compression, and axial torsion\u2014and compared the stress distribution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found that under axial compression, Model II experienced its maximum stress on the plate at 551.9MPa, which was less than that in Model I (790.4 MPa). Moreover, a greater stress concentration at the fracture site was observed under axial torsion, despite the maximum stress of both the models being similar.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Canceling the notch and filling the screw holes near the fracture can ameliorate stress concentration on the internal fixation construct and enhance its reliability under axial compression. This improvement has substantial effects on the mechanical properties of implants and potentially prevents implant failure. Modern osteosynthesis anatomical implants need to be improved.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13558","type":"journal-article","created":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T10:25:56Z","timestamp":1667989556000},"page":"2152-2156","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Canceling Notch Improves the Mechanical Safety of Clavicle Locking Plate: A <scp>3D<\/scp> Finite Element Study"],"prefix":"10.1111","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3128-3077","authenticated-orcid":false,"given":"Zhihua","family":"Han","sequence":"first","affiliation":[{"name":"Trauma Center, Department of Orthopaedics and Traumatology, Shanghai General Hospital Shanghai Jiaotong University  Shanghai China"},{"name":"Sino\u2010Euro Orthopaedics Network  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qian","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Radiology, Shanghai General Hospital Shanghai Jiaotong University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guoying","family":"Deng","sequence":"additional","affiliation":[{"name":"Trauma Center, Department of Orthopaedics and Traumatology, Shanghai General Hospital Shanghai Jiaotong University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun","family":"Bi","sequence":"additional","affiliation":[{"name":"Trauma Center, Department of Orthopaedics and Traumatology, Shanghai General Hospital Shanghai Jiaotong University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gang","family":"Yin","sequence":"additional","affiliation":[{"name":"Trauma Center, Department of Orthopaedics and Traumatology, Shanghai General Hospital Shanghai Jiaotong University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5414-7516","authenticated-orcid":false,"given":"Haodong","family":"Lin","sequence":"additional","affiliation":[{"name":"Trauma Center, Department of Orthopaedics and Traumatology, Shanghai General Hospital Shanghai Jiaotong University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianhong","family":"Wu","sequence":"additional","affiliation":[{"name":"Trauma Center, Department of Orthopaedics and Traumatology, Shanghai General Hospital Shanghai Jiaotong University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoming","family":"Wu","sequence":"additional","affiliation":[{"name":"Trauma Center, Department of Orthopaedics and Traumatology, Shanghai General Hospital Shanghai Jiaotong University  Shanghai 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