{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T13:09:55Z","timestamp":1789564195194,"version":"build-2803163510"},"reference-count":14,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Proc Inst Mech Eng H"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>\n                    This study quantified the biomechanical consequences of incremental far-cortex over-penetration at terminal locking screw positions in a locking compression plate construct using a validated three-dimensional finite element model of a femoral diaphyseal fracture (AO\/OTA 32-A3). Four terminal screw engagement configurations were evaluated: unicortical fixation, fully contained bicortical fixation, 1-thread over-penetration (0.6\u2009mm), and 3-thread over-penetration (1.8\u2009mm). Axial compression (1000 N), torsional loading (\u00b110\u2009Nm), and cyclic dynamic loading (100\u20131000\u2009N, 1\u2009\u00d7\u200910\n                    <jats:sup>6<\/jats:sup>\n                    cycles) simulating the 8-week early postoperative period were applied. Model validation against published experimental data demonstrated agreement within 4% for all key biomechanical parameters. Fully contained bicortical fixation was the only configuration to remain below the predicted fatigue threshold, demonstrating the lowest peak von Mises stress (74.8\u2009MPa) and a Miner\u2019s cumulative damage index of\n                    <jats:italic toggle=\"yes\">D<\/jats:italic>\n                    \u2009=\u20090.291. Unicortical fixation (\n                    <jats:italic toggle=\"yes\">D<\/jats:italic>\n                    \u2009=\u20091.103), 1-thread over-penetration (\n                    <jats:italic toggle=\"yes\">D<\/jats:italic>\n                    \u2009=\u20091.362), and 3-thread over-penetration (\n                    <jats:italic toggle=\"yes\">D<\/jats:italic>\n                    \u2009=\u20092.968) all exceeded the failure threshold (\n                    <jats:italic toggle=\"yes\">D<\/jats:italic>\n                    \u2009\u2265\u20091.0). Under the loading conditions and material assumptions of the present finite element model, unicortical terminal fixation alone did not sustain simulated cyclic physiological loading during the pre-callus phase without exceeding the predicted fatigue damage threshold. These findings provide preliminary, model-dependent computational evidence suggesting that fully contained bicortical fixation may offer greater fatigue resistance, and that the biomechanical basis of current terminal screw placement guidelines warrants further experimental investigation.\n                  <\/jats:p>","DOI":"10.1177\/09544119261476357","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T02:29:41Z","timestamp":1786069781000},"page":"902-910","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Biomechanical effects of far-cortex over-penetration in locking plate fixation: A finite element study"],"prefix":"10.1177","volume":"240","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6784-4636","authenticated-orcid":false,"given":"Natig","family":"Valiyev","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Traumatology, \u00dcmraniye Training and Research Hospital, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cihan","family":"Zaman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Sar\u0131kam\u0131\u015f State Hospital, Kars, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","unstructured":"Basirom I Daud R Ijaz MF et al. Stability analysis of plate-screw fixation for femoral midshaft fractures. Materials 2023; 16(17): 5958. https:\/\/doi.org\/10.3390\/ma16175958","DOI":"10.3390\/ma16175958"},{"key":"e_1_3_2_3_2","doi-asserted-by":"crossref","unstructured":"Hu J Peng Y Li J et al. Spatial bridge locking fixator versus traditional locking plates in treating AO\/OTA 32-A3.2 fracture: finite element analysis and biomechanical evaluation. Orthop Surg 2022; 14(8): 1638\u20131648. https:\/\/doi.org\/10.1111\/os.13308","DOI":"10.1111\/os.13308"},{"key":"e_1_3_2_4_2","doi-asserted-by":"crossref","unstructured":"Zdero R Gide K Brzozowski P et al. Biomechanical design optimization of distal femur locked plates: a review. 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