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The study aims to create a time-dependent finite element (FE) model to assess the impacts of different screw configurations on LCP fixation stiffness and healing efficiency across four healing stages during a complete fracture healing process. To simulate the healing process, we integrated a time-dependent callus formation mechanism into a FE model of the LCP with combi-holes. Three screw configuration parameters, namely working length, screw number, and screw position, were investigated. Increasing the working length negatively affected axial stiffness and healing efficiency ( p\u2009&lt;\u20090.001), while screw number or position had no significant impact ( p\u2009&gt;\u20090.01). The time-dependent model displayed a moderate correlation with the conventional time-independent model for axial stiffness and healing efficiency (\u03c1\u2009\u2265\u20090.733, p\u2009\u2264\u20090.025). The highest healing efficiency (95.2%) was observed in screw configuration C125 during the 4\u20138-week period. The results provide insights into managing fractures using LCPs with combi-holes over an extended duration. Under axial compressive loading conditions, the use of the C125 screw configuration can enhance callus formation during the 4\u201312-week period for transverse fractures. When employing the C12345 configuration, it becomes crucial to avoid overconstraint during the 4\u20138-week period.<\/jats:p>","DOI":"10.1177\/09544119241229157","type":"journal-article","created":{"date-parts":[[2024,2,19]],"date-time":"2024-02-19T05:34:05Z","timestamp":1708320845000},"page":"313-323","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Biomechanical analysis of combi-hole locking compression plate during fracture healing: A numerical study of screw configuration"],"prefix":"10.1177","volume":"238","author":[{"given":"Zeyang","family":"Li","sequence":"first","affiliation":[{"name":"School of Engineering, Cardiff University, Cardiff, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart","family":"Pollard","sequence":"additional","affiliation":[{"name":"School of Engineering, University of Birmingham, Birmingham, 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