Design and Development of Novel Anatomical Scapular Fracture Fixation Plates: Population-Based and Fracture-Focused Design

Abstract

Surgical fixation is a recommended procedure for displaced and unstable scapular fractures to restore anatomical alignment and articular congruency of the fracture fragments. Anatomically Precontoured scapular plates are designed to guide the fracture reduction, used as a template, and stabilize the fixation. However, anatomical variation of the scapula and the complexity of the fracture patterns limit the usability of these plates. The aim of this study was to design and develop population-based novel anatomical scapular plates. An average three-dimensional (3D) scapular bone model was developed from 22 healthy cadaver scapulae of target population (South Africans) using Statistical Shape Modelling (SSM) method. The fracture region of interests was identified using a fracture map of 70 scapular fracture patterns. Using the average 3D scapular model as a reference template and the common fracture zones as a reference fracture pattern, anatomical plates were designed for the critical scapula fracture patterns. Lateral border, medial border, glenoid fossa & neck, glenoid fossa & body, and acromion plates were designed. Combining 3D CT image based statistical shape modelling and fracture pattern analysis with CAD is relatively quick and efficient method to develop clinically meaningful population-based anatomical plates.