Finite element analysis of force-multiplying bridge structure applied in screw internal fixation for distal radius type C fractures

To investigate the differences in biomechanical performance between the Bailey bridge screw fixation system derived from truss units and the conventional volar locking plate-screw fixation system in the treatment of type C distal radius fractures, and to explore a simpler and minimally invasive internal fixation configuration. Based on the radial CT data of a healthy female volunteer, a finite element model of type C distal radius fracture was established, and the plate-screw group (PS group) and the Bailey bridge screw group (FMB group) were assembled respectively, with 2.7 mm screws adopted in both groups. Material parameters, boundary conditions and four physiological loading conditions (axial, rotational, palmar flexion, dorsiflexion) were set uniformly. The mesh size of 1 mm was determined through mesh convergence analysis, and the deformation scale factor of 1.0 and the color scale range of 0 ~ 0.66 mm were unified. The displacement amplitudes of the two groups of models were compared at the levels of the overall structure, internal fixation devices and articular surface. The maximum displacement amplitudes of the PS group under axial, palmar flexion and dorsiflexion conditions were 0.1636, 0.3760 and 0.0915 mm, respectively, with a reduction of 32.7, 37.7 and 84.9% compared with the FMB group, showing better rigidity. The FMB group exhibited advantages only under the rotational condition, with a maximum displacement amplitude of 0.2308 mm, a 65.0% reduction compared with the PS group. In terms of displacement distribution, the PS group showed a characteristic of local concentration, with high-displacement areas located at the contact area between the plate and the fracture end, the distal screw holes of the plate, and the dorsal and ulnar margins of the articular surface; the FMB group presented uniform displacement distribution at the fracture end, each screw and the entire articular surface without obvious concentrated areas. At the level of internal fixation devices, the displacement of the plate in the PS group was concentrated at the distal screw holes, while the displacement of the truss screws in the FMB group was evenly distributed. Moreover, the FMB group achieved fixation performance comparable to that of the PS group with less material. The conventional plate-screw fixation system has higher overall rigidity under multi-directional loads, and is suitable for patients with type C distal radius fractures who require rigid fixation and early weight-bearing. The Bailey bridge screw fixation system realizes load distribution by virtue of the truss structure, which has the advantage of minimal invasiveness and excellent stability under rotational condition, making it suitable for patients pursuing minimally invasive treatment and requiring early rotational functional exercise. This study provides a new option for the individualized internal fixation treatment of type C distal radius fractures, and also offers a new idea for the interdisciplinary integrated design of engineering structural science and orthopedics.