Mohammed Rashid, Karim Husain, Nikola Vitković, Miodrag Manić, Slađana Petrović

DOI Number
First page
Last page


Plate implants are the most used internal fixators for the surgical treatments of the bone fractures. In clinical cases where there is a requirement to use reconstruction plates, and/or to stabilize the fracture, adaptation of plate shape (e.g. bending) to the patient anatomy is required, and it is usually done during the surgery. In order to eliminate the need for intra-operative bending of plates, precontoured plates can be used. These are patient specific implants whose shape and geometry is adapted to the anatomy and morphology of the specific patient. In order to create a patient specific 3D model of the plate implant, the bone model acquired through medical imaging (e.g. Computed Tomography - CT) is commonly used. By the application of various CAD techniques, the volume model of specific plate implant can be created, and used for the production of the plate, by conventional or additive manufacturing technologies. In this paper the authors present a new approach to the creation of a 3D parametric model of the patient specific plate implant for distal humerus. By using such model the surgeon can perform preoperative planning and adapt shape of plate to the specific patient before the surgery, and in this way he can improve pre, intra and post-operative processes.


CAD, Orthopedic, Fixator, Plate, Parametric models, Method of Anatomical Features

Full Text:



Fragomen, A.T., Rozbruch , S.R., 2007, The Mechanics of External Fixation, HSS Journal, 3(1), pp. 13-29.

Grewal, R., MacDermid, J.C., King, G. J., Faber, K. J., 2011, Open reduction internal fixation versus percutaneous pinning with external fixation of distal radius fractures: a prospective, randomized clinical trial, J Hand Surg Am, 36(12), pp. 1899-906.

Bacon, S., Smith, W. R., Morgan, S. J., Hasenboehler, E., Philips, G., Williams, A., Ziran, B. H., Stahel, P. F., 2008, A retrospective analysis of comminuted intra-articular fractures of the tibial plafond: Open reduction and internal fixation versus external Ilizarov fixation, Injury, 39(2), pp. 196-202.

Uhthoff, H. K., Poitras, P., Backman, D., 2006, Internal plate fixation of fractures: short history and recent developments, Journal of Orthopaedic Science, 11(2), pp. 118–126.

Musuvathy, S., Azernikov, S., Fang, T., 2011, Semi-automatic customization of internal fracture fixation plates, Engineering in Medicine and Biology Society, EMBC, 2011 Annual International Conference of the IEEE, Boston MA, Aug. 30 2011-Sept. 3, pp. 595 – 598.

Vitković, N., Milovanović, J., Korunović, N., Trajanović, M., Stojković, M., Mišić, D., Arsić, S., 2013, Software System for Creation of Human Femur Customized Polygonal Models, COMSIS - Computer Science and Information Systems, 10(3), pp.1473-1497.

Majstorovic, M., Trajanovic, M., Vitkovic, N., Stojkovic, M., 2013, Reverse engineering of human bones by using method of anatomical features, CIRP Annals - Manufacturing Technology, 62(1), pp. 167-170.

Penzkofer, R., Hungerer, S., Wipf, F., Oldenburg, V.G., Augat, P., 2010, Anatomical plate configuration affects mechanical performance in distal humerus fractures, Clinical Biomechanics, 25(10), pp.972-978.

O'Driscoll, S.W., 2005, Optimizing stability in distal humeral fracture fixation, J Shoulder Elbow Surg., 14(1 Suppl S), pp.186S-194S.

AO Foundation, Plate fixation and Open Reduction,, (last access: 10.05.2016.)

Scolaro, J.A., Hsu, J.E., Svach, D.J., Mehta, S., 2014, Plate selection for fixation of extra-articular distal humerus fractures: a biomechanical comparison of three different implants, 45(12), pp. 2040-2044.

Lešić, A., Zagorac, S., Bumbaširević, V., Bumbaširević, M., 2012, The development of internal fixation: Historical overview, Acta chirurgica iugoslavica, 59(3), pp. 9-13.

Rucci, N., 2008, Molecular biology of bone remodelling, Clin Cases Miner Bone Metab, 5(1), pp. 49–56

Costa, L.M., Achten, J., Parsons,R.N., Rangan,A., Griffin, D., Tubeuf, S., Lamb E.S., 2014, Percutaneous fixation with Kirschner wires versus volar locking plate fixation in adults with dorsally displaced fracture of distal radius: randomised controlled trial, BMJ 2014, 349:g4807

Takigami, H., Sakano, H., Saito, T., 2010, Internal fixation with the low profile plate system compared with Kirschner wire fixation: clinical results of treatment for metacarpal and phalangeal fractures, Hand Surg, 15(1), pp.1-6.

Henry, M.H., 2008, Fractures of the proximal phalanx and metacarpals in the hand: preferred methods of stabilization, J Am Acad Orthop Surg, 16(10), pp.586-95.

Bhandari, M., Tornetta, P., Hanson, B., Swiontkowski, M.F., 2009, Optimal internal fixation for femoral neck fractures: multiple screws or sliding hip screws?, J Orthop Trauma, 23(6), pp.403-407

Lindsey, R.W., Ahmed, S., Overturf, S., Tan, A., Gugala, Z., 2009, Accuracy of lag screw placement for the dynamic hip screw and the cephalomedullary nail, Orthopedics, 32(7), pp. 488

AO Foundation, Screws page,, (last access: 10.05.2016.)

Uhthoff, K.H., Poitras, P., Backman, S.D., 2006, Internal plate fixation of fractures: short history and recent developments, J Orthop Sci, 11(2), pp. 118–126.

Lai, Y.C., Tarng, Y.W., Hsu, C.J., Chang, W.N., Yang, S.W., Renn, J.H., 2012, Comparison of Dynamic and Locked Compression Plates for Treating Midshaft Clavicle Fractures, Orthopedics, 35(5), pp. 697-702.

Frigg, R., Wagner, M., Frenk, A., 2008, Locking compression plates (LCP) & less invasive stabilization system (LISS), Eur Cell Mater, 16(5), p. 5

Gardner, M.J., Helfet, D.L., Lorich, D.G., 2004, Has Locked Plating Completely Replaced Conventional Plating?, Am J Orthop (Belle Mead NJ), 33(9), pp. 440-446.

Berkin, C.R., Marshall, D.V., 1972, Three-sided plate fixation for fractures of the tibial and femoral shafts: a follow-up note, J Bone Joint Surg Am, 54(5), pp.1105–1113.

Perren, S.M., Cordey, J., Rahn, B.A., Gautier, E., Schneider, E., 1988, Early temporary porosis of bone induced by internal fixation implants: a reaction to necrosis, not to stress protection?, Clin Orthop, 232 pp.139–151

Jain, R., Podworny, N., Hupel, T.M., Weinberg, J., Schemitsch, E.H., 1999, Influence of plate design on cortical bone perfusion and fracture healing in canine segmental tibial fractures, J Orthop Trauma, 13(3), pp.178–86.

Walsha, S., Reindla, R., Harveya, E., Berrya, G., Beckmanb, L., Steffenb, T., 2006, Biomechanical comparison of a unique locking plate versus a standard plate for internal fixation of proximal humerus fractures in a cadaveric model, Clin Biomech, 21(10), pp.1027–1031.

Rose, P.S., Adams, C. R., Torchia, M.E., Jacofsky, D.J., Haidukewych, G.G., Steinmann, S.P., 2006, Locking plate fixation for proximal humeral fractures: initial results with a new implant, J Shoulder Elbow Surg, 16(2), pp. 202-209

Sanders, B.S., Bullington, A.B., McGillivary, G.R., Hutton, W.C., 2007, Biomechanical evaluation of locked plating in proximal humeral fractures, J Shoulder Elbow Surg, 16(2), pp.229-34

Koonce, R.C., Baldini, T.H., Morgan, S.J., Are conventional reconstruction plates equivalent to precontoured locking plates for distal humerus fracture fixation? A biomechanics cadaver study, Clin Biomech (Bristol, Avon), 27(7), pp. 697-701.

Lan, X., Zhang, L.H., Tao, S., Zhang, Q., Liang, X.D., Yuan, B.T., Xu W.P., Yin, P., Tang, P.F.,2013, Comparative study of perpendicular versus parallel double plating methods for type C distal humeral fractures, Chinese medical journal, 126(12), pp.2337-2342.

Ristić, M., Manić, M., Mišić, D., Kosanović, M., Mitković, M., 2017, Implant material selection using expert system, Facta Universitatis-Series Mechanical Engineering, 15(1), pp.133-144.

Stojkovic, M., Veselinovic, M., Vitkovic, N., Marinkovic, D., Trajanovic, M., Arsic, S., Mitkovic, M., 2018, Reverse modeling of human long bones using T-splines - case of tibia, Tehnicki Vjesnik, accepted for publishing.

Rashid, M., Husain, K., Vitković, N., Manić, M., Trajanović, M., Milovanović, J., Radović, Lj., 2015, Reverse modeling of human humerus by the method of anatomical features (MAF), Proceedings of The Seventh International Working Conference, Total Quality Management – advanced and intelligent approaches (TQM 2015) 2nd – 5th June 2015, Belgrade. Serbia, pp. 197-202.



  • There are currently no refbacks.

ISSN: 0354-2025 (Print)

ISSN: 2335-0164 (Online)

COBISS.SR-ID 98732551

ZDB-ID: 2766459-4