Biomechanical evaluation of composite reduction plates with variable positioning using the Henry and Thompson approaches for transverse radial fracture surgery

Background: Radius fractures are challenging to stabilize due to complex muscle-loading conditions, requiring optimized plate positioning and material selection for effective treatment. This study addresses the biomechanical impact of plate positions (anterior, posterior, lateral) and materials in transverse radial fractures. Hypothesis: Plate positioning and material selection significantly influence stress distribution and displacement, with lateral positioning and WE43 alloy offering biomechanical advantages. Methods: Finite element analysis was used to evaluate Ti6Al4V titanium alloy and WE43 magnesium alloy bone plates positioned on the anterior, posterior, and lateral sides of the radius under a 50 N axial load. Stress distribution and displacement were analyzed. Results: Posterior reductions exhibited the highest stress and displacement, indicating potential instability, with maximum von Mises stress increasing by 32.5% compared to anterior reduction. Lateral reductions provided more uniform stress distribution and lower displacement, though von Mises stress was still 20% higher than in the anterior reduction. WE43 alloy demonstrated effective stress reduction in non-posterior positions, while Ti6Al4V exhibited greater stiffness and resistance to deformation. Discussion: Lateral and anterior plate positions demonstrated superior biomechanical stability, suggesting their preference for optimizing fracture healing and reducing complications. WE43 alloy's stress-reducing and biodegradable properties make it suitable for temporary fixation, while Ti6Al4V provides greater structural integrity for long-term support. These findings highlight the importance of plate positioning and material selection in improving clinical outcomes for transverse radial fracture fixation. Level of evidence: V; expert opinion, controlled laboratory study.