Comparison of different plate constructs in a canine femoral gap fracture model: An “In-silico” biomechanical study

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Iván Serra, Manuel Ibañez, Tomás Serrano-Crehuet, Carme Soler, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7373003/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 8 You are reading this latest preprint version Abstract Background: Femoral fractures are a common occurrence in canine patients, accounting for a significant proportion of long bone fractures. Diaphyseal fractures, particularly comminuted ones, pose a challenge due to the need for robust stabilization systems that can withstand various mechanical loads. Orthogonal plate constructs have been proposed as a solution, but their biomechanical behaviour in comminuted femoral fractures has not been extensively studied. This study aims to evaluate the mechanical performance of different orthogonal plate configurations in a canine femoral gap fracture model using in-silico biomechanical analysis. Results: The study compared three models: a single lateral plate (Model A), a lateral plate with a cranial plate (Model B), and a lateral plate with a caudal plate (Model C). The results showed that Model C exhibited superior mechanical properties, including lower stress concentrations and higher factors of safety (FoS). Model C achieved a FoS 7.99 times larger than Model A and 1.72 times larger than Model B. The stress distribution analysis revealed that the caudal plate in Model C acted as the primary load-bearing element, effectively distributing the load and reducing the risk of implant failure. This was consistent with the alignment of the caudal plate with the load forces, which attracted more stress and minimized bending moments. Conclusions: Orthogonal plate constructs, particularly those with a caudal plate, provide enhanced mechanical stability in comminuted femoral fractures. The findings suggest that the caudal plate configuration offers better performance under compressive loads, making it a preferable choice for clinical applications. Despite the study's limitations, including the use of theoretical models and data from a single individual, the results support the potential applicability of these constructs in future studies and clinical practice. Canine in silico biomechanical analysis femoral gap fracture orthogonal plates Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Background Femoral fractures account for 20–25% of all fractures and 45% of long bone fractures. Diaphyseal fractures account for 56% of the total, with a significant proportion of them being comminuted 1 . These types of fractures require stabilization systems under the concept of bridging osteosynthesis, a construct that increases the risk of implant failure due to working length plate increment and the absence of load-sharing between the main fragments 2 . These osteosynthesis systems are mechanically demanding, as they must withstand all loads and resist applied forces on the bone 1 . Various stabilization strategies to “reinforce” bridge-plate constructs have been used over the years, including larger plate sizes, plate-rod fixation, double plating, orthogonal plating, dual bone fixation, and stack plating 2 – 5 . Orthogonal locking plates have proven to be particularly useful in many types of comminuted fractures, and the femoral bone is one of the most representative examples of these constructs 2 , 3 , 6 . A bone, depending on each moment, is exposed to different forces. Similarly, in the event of a fracture, forces must be withstood by the implants with or without bone, as in the case of comminuted fractures. It is known, that osteosynthesis plate application on the bone tension surface acts as an interfragmentary tension band, while there is no bone defect on the contralateral side 7 , the situation presents in the bridging plates for comminuted fractures. Therefore, it is not clear if the ideal side for the plate application, thinking of its biomechanical behaviour in comminuted fractures, should be the tension or the compression bone surface. This is of particular interest in orthogonal plates, as in this case there is more freedom to apply a second plate on one or other surface. In the case of the canine femur, Sahar et al (2003) 8 described the stress and strain distribution, defining the lateral and cranial surfaces as tension surfaces and the caudal and medial surfaces as compression surfaces. In diaphyseal femoral fractures, plates are conventionally applied on the lateral bone surface. Assuming a mechanical weakness in comminuted fractures, orthogonal plates have been implemented among other constructions. In these cases, the second plate is usually applied on the cranial femoral surface, which is also considered the tension femoral surface 8 . However, limited studies have been performed evaluating this construct’s biomechanical behaviour and the possibility of other types of plate distribution. Over time, different biomechanical studies have been carried out to assess the behaviour of implants and their application in long bone fractures, mainly “in vitro” tests. Currently, computational biomechanics provides tools to simulate the mechanical behaviour of anatomical regions and their implant interaction. In-silico analyses and their simulations have become valuable alternatives replacing, reducing, and refining experimental studies in animal and “in vitro” models. Thus, Three-dimensional finite element analysis (FEA) can determine the displacements, stresses, and strain on an implant, or complex fracture construction, under different applied forces 9 , 10 , 11 . To assess which orthogonal plate distribution would offer the best mechanical behaviour in a diaphyseal femoral gap fracture, the purpose of the present study was to evaluate the plate strain and construct stress distribution in two proposed orthogonal plate systems. The authors hypothesised that (1) the use of orthogonal plates provides superior biomechanical behaviour to the use of single plates, and (2) adding the second plate on the caudal femoral surface (compression side), instead of cranial (tension side), would show better mechanical behaviour in loading tests. For this, an in silico using the hip joint reaction force test was conducted. Results Figure 1 shows the maximum stress produced in each model with respect to the applied load. Model C exhibits lower von Mises stress than Model B, which in turn exhibits lower stress than Model A for every compression load throughout the test. This indicates that under the same compression load, Model C produces less internal stress than the other models. In numerical terms, Model C achieves a Factor of Safety (FoS) 7.99 times larger than Model A and 1.72 times larger than Model B. Consequently, Model B achieves a FoS 4.62 times larger than Model A. Figure 2 shows the stress distribution obtained through FEA. Model A exhibits a high concentration of stress on the area of the plate over the gap fracture, with negligible stress on the rest of the plate. Model B shows a more extended stress distribution, the maximum stress being on the lateral plate. Model C also shows a more extended stress distribution, the maximum stress being on the caudal plate. Discussion The results support the first hypothesis. Orthogonal models demonstrated more robust mechanical properties compared to the single-plate system across all tests and variables. These findings align with previous studies, which indicate that orthogonal systems increase construct stiffness, load to failure, decrease plate strain and stress, and enhance implant fatigue life. These superior mechanical properties are attributed to greater area moment of inertia (AMI) and polar moment of inertia (PMI) compared to single plate constructs 2 , 3 , 6 . Therefore, orthogonal plates are recommended for use in bridging systems for comminuted fractures. Highly comminuted fractures force implants to: (1) work with greater working lengths, and (2) support the totality of forces applied to the bone, as there is no contact between bone fragments 2 , 7 . This results in an increased risk of implant fatigue and system failure. To compensate for these deficiencies, different strategies have been developed, the most common being the rod-plate, orthogonal, and parallel plates 2 , 3 , 5 , 12 – 14 . The main advantages of double plate systems are minimizing the effect of the working length plate 2 , the possibility of being used in distal fractures with small fragments and allowing an increase in the number of screws in each fragment. The disadvantage is the need for more extensive surgical approaches, affecting the integrity of the soft tissue and bone. The use of locking plates and minimally invasive procedures can help to minimize these effects 15 . In clinical practice, the use of orthogonal plates in long bone fractures also seems to show advantages, with the presence of fewer post-surgical complications, although there are still few studies in veterinary medicine 3 , 16 , 17 . The second hypothesis of this study was also confirmed. Placing the second plate on the femoral compressive side (caudal surface) resulted in lower stress and better fatigue resistance during compressive loading tests. Under axial compression, the maximal stress resisted by the three structural elements (bone, plate, and screws) was lower in the orthogonal system with lateral and caudal plates (Model C) compared to the orthogonal system with lateral and cranial plates (Model B). These results can be explained by the alignment of forces in the hip-joint reaction force model. According to femur anatomy, the line connecting both diaphysis centres is closer to the caudal face than to the cranial face 8 (see Fig. 3 and Fig. 4 ). This means the plate on the caudal face is more aligned with the load forces than the plate on the cranial face 7 . A more aligned plate reduces bending moments and thus the stress produced by them. The FoS values obtained in this study further support the superiority of the orthogonal plate constructs. Model C achieved a FoS 7.99 times larger than Model A and 1.72 times larger than Model B, indicating significantly higher stability and resistance to failure. These values are notably large, which suggests that even if the specific values cannot be directly extrapolated to other individuals, Model C is likely to remain superior to Models B and A in terms of mechanical performance. Consequently, Model B also demonstrated a FoS 4.62 times larger than Model A, reinforcing the benefits of using orthogonal plates over single plate systems. The stress distribution results also highlight the advantages of Model C. In the compression simulations, Model C exhibited a more evenly distributed stress pattern across the caudal plate, reducing the concentration of stress at any single point. In Model A, the lateral plate is the sole component bearing all the stress, making it the primary load-bearing element. In Model B, the cranial plate supports the lateral plate, distributing the stress between them. However, in Model C, the caudal plate becomes the primary load-bearing element, with the lateral plate providing additional support. This shift in the primary load-bearing element to the caudal plate in Model C contributes to its superior mechanical performance and lower risk of implant failure. This is consistent with the earlier explanation of why Model C performs better under compressive loads. The central alignment of the caudal plate with the load forces means it attracts more stress, effectively distributing the load and reducing the risk of localized stress concentrations that could lead to implant failure 14 , 18 – 21 . This study has several limitations that should be acknowledged. Firstly, the "in silico" nature of the study assumes certain theoretical models and simplifications, such as linear elasticity and isotropy in the bone, and perfect bonding between the bone and screws, as well as between the plate and screws. Secondly, the geometric data was obtained from the femur of a single individual, which may not be representative of the broader canine population. Thirdly, the specific models tested, including the sizes of the plates and the number and positions of the screws, are relevant to the mechanical behaviour observed, and other configurations could yield different results. Despite these constraints, the authors propose the potential applicability of this model in future studies. Conclusion This study evaluated the biomechanical performance of different orthogonal plate constructs in a canine femoral gap fracture model using in-silico analysis. Orthogonal plates, especially those with a caudal plate, demonstrated superior mechanical properties compared to single plate systems. The caudal plate configuration exhibited the highest factor of safety and the most evenly distributed stress pattern, making it the preferable choice for stabilizing comminuted femoral fractures. The caudal plate configuration offers better performance under compressive loads, potentially reducing post-surgical complications and improving implant longevity. Despite the study's limitations, the results support the potential applicability of these constructs in future studies and clinical practice. In conclusion, orthogonal plate constructs, particularly with a caudal plate, provide enhanced mechanical stability and are recommended for use in bridging systems for comminuted femoral fractures in canine patients. Methods Geometric definition: On one hand, preparation of the geometric model for biomechanical simulation began with data extraction from computed tomography (CT) images using the software 3D Slicer (Version 5.4.0, https://www.slicer.org/ ). The femoral bone of an eight-year-old neutered golden retriever, displaying no orthopaedic abnormalities, underwent scanning using a multidetector 16-slice Computed tomography scanner (Siemens Somatom Scope, Munich, Germany) in helical scan mode. The CT acquisition adhered to specific protocols and technique settings, including a 512 × 512 matrix, a pitch of 0.8 with a scan thickness of 1.00 mm and operating at 170 mAs and 130 kV. The data processing consisted of isolating the bone of interest, cleaning of artifacts and other noise, and segmenting by bone density to differentiate and model cortical and trabecular bone independently. The resulting geometries were exported in three-dimensional mesh format, in this case (.OBJ), suitable for digital manipulation. On the other hand, the titanium plates and screws used in the bone fixation were modelled. This modelling is based on the manufacturer's technical specifications, respecting thickness, distance between holes, and all other dimensions. The fixation screws were simplified as cylinders for the numerical evaluation in accordance with the literature 22 , 23 . Since in clinical practice it is common to bend some plates prior to surgery to adapt them to the curvature of the bone, some of the plate models were bent using software to make the geometric definition as realistic as possible. This was done using Rhinoceros 3D software (Version 7, https://www.rhino3d.com ). The bone models and plates were then imported into ANSYS simulation software (Version 17, https://www.ansys.com/ ). Using the SpaceClaim geometry manager, the plates were positioned at the required locations for each analysis. A 1.0mm gap fracture was simulated in the mild diaphysis, and Boolean operations were applied to model the interaction between the metal parts and the bone. Some preliminary simulations showed that the trabecular bone did not influence the stress distribution across the cortical bone and plate, so we removed it to simplify the output model. The resulting mesh consisted of about 130000 elements and 230000 nodes with a maximum edge size of 1.7 mm. Figure 5 shows the result of both parts and the final assembly. Mechanical definition: The FEA was executed in the Static Structural Analysis module, from the ANSYS simulation software. Both materials, bone and plate were defined using the elastic model with parameters shown in Table 1 . The contact areas between the bone and the screws were defined as bonded. Anatomic loading areas were determined at the femur following the hip joint reaction force 5 . Figure 6 shows the faces selected for both surfaces. For the load conditions, the femoral head was defined as fixed support, and the external load was uniformly applied over the condylar surface. The maximum compression load was set as 1000 N. The loads were defined as linear transient from 0 to the maximum value. Table 1 Mechanical properties used in the simulation. Material Young Yield strength Titanium 1e9 1e6 Bone 2e9 2e6 Experiment design: Three different construction methods were used in a gap fracture model of the femur: Model A: A single 12-hole lateral locking plate was used, fixed with 8 screws (6 in the central holes and 2 at the ends). Model B: A 12-hole lateral locking plate and an 8-hole cranial locking plate were used. The lateral plate was fixed with 4 screws (2 in the central holes and 2 at the ends), and the cranial plate was fixed with 4 screws at the ends, ensuring no collisions. Model C: A 12-hole lateral locking plate and an 8-hole caudal locking plate were used. The lateral plate was fixed with 4 screws (2 in the central holes and 2 at the ends), and the caudal plate was fixed with 4 screws at the ends, ensuring no collisions. All plates were fixed using 3.5 mm bi-cortical titanium locking screws. Figure 7 shows the placement of the plates and screws. A compression tests was performed in each construction method. For each model, the most stressed point along the evolution of the external load is determined. For that point, the load (N) and stress (N/mm2) were determined. Results were obtained and compared between the three models. Abbreviations FoS factors of safety FEA finite element analysis AMI area moment of inertia PMI polar moment of inertia CT computed tomography N newtons Declarations Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Availability of data and materials: The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Competing interest: The authors declare that they have no competing interests. Funding: Publication fees will be paid by the Vice-Rectorate for Research at the Catholic University of Valencia. Authors´ Contributions: CIS was responsible for conceptualising the work, interpreting the data, and writing the paper; MI performed data acquisition and analysis, as well as reviewing the methodology section of the article; TS participated in the design of the work and data acquisition, CS participated in the study design, interpretation of results, and performed the final review of the work; LD participated in the conceptualisation and design of the study, was instrumental in interpreting the results, and participated in the final review of the work. Acknowledgments: Not applicable References Guiot LP, Déjardin LM. Chapter 60: Fractures of the femur. In: Spencer A. Johnston and Karen M. Tobias, editors. Veterinary Surgery Small Animal. 2nd Ed. Missouri (USA); Elsevier; 2018. p.1019-70. De Bruyne B, Glyde M, Day R, Hosgood G. Effect of orthogonal locking plate and primary plate working plate length on construct stiffness and plate strain in an in vitro fracture-gap model. 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Vet Comp Orthop Traumatol. 2024;37:V-VI. Higuchi M, Katayama M. Clinical outcomes of orthogonal plating to treat radial and ulnar fractures in toy-breed dogs. Journal of Small Animal Practice. 2021;62(11):1-6. Renwick A, Scurrell E. Orthogonal bone plate stabilization for limb-sparing surgery. Vet Comp Orthop Traumatol. 2013;26:505-9. Schemitsch EH, Tencer AF, Henley MB. Biomechanical evaluation of methods of internal fixation of the distal humerus. J Orthop Trauma. 1994;8:468-75. Schwartz A, Oka R, Odell T, Mahar A. Biomechanical comparison of two different periarticular plating systems for stabilization of complex distal humerus fractures. Clin Biomech. 2006;21:950-5. Taylor PA, Owen JR, Benfield CP, Wayne JS, Boardman ND. Parallel plating of simulated distal humerus fractures demonstrates increased stiffness relative to orthogonal plating with a distal humerus locking plate system. J Orthop Trauma. 2016;30 e118-22. Mittag U, Kriechbaumer A, Rittweger J. 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Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 28 Sep, 2025 Reviewers agreed at journal 25 Sep, 2025 Reviewers agreed at journal 23 Sep, 2025 Reviewers invited by journal 18 Sep, 2025 Editor invited by journal 19 Aug, 2025 Editor assigned by journal 18 Aug, 2025 Submission checks completed at journal 18 Aug, 2025 First submitted to journal 14 Aug, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7373003","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":521867812,"identity":"8d84a352-15b0-45de-86c5-6faa0183eae5","order_by":0,"name":"C. 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1","display":"","copyAsset":false,"role":"figure","size":26189,"visible":true,"origin":"","legend":"\u003cp\u003eStress obtained at the more stressed point during compression for each model\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7373003/v1/0f9de85b98e1b80efde45040.png"},{"id":92529840,"identity":"68b70cd1-2e36-4fa9-b543-a5a661efecbc","added_by":"auto","created_at":"2025-09-30 16:35:59","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":540921,"visible":true,"origin":"","legend":"\u003cp\u003eStress distribution in compression simulation for Models A(A) B(B) and C (C)\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-7373003/v1/7347bcec9363789372c14e6b.png"},{"id":92532353,"identity":"b09fa25f-9036-4bea-8f73-45dfd8f760f4","added_by":"auto","created_at":"2025-09-30 16:51:59","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":244138,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eLine between the load surface centres and its relative position with the plates in B and C systems\u003c/em\u003e\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-7373003/v1/95320481575b16bfe543d559.png"},{"id":92532355,"identity":"77336c4e-2081-4cb5-bd6b-c5d0994fd741","added_by":"auto","created_at":"2025-09-30 16:51:59","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":235518,"visible":true,"origin":"","legend":"\u003cp\u003eTransversal view of the assembly from the point of view of the gap with a point representing the line connecting both diaphysis.\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-7373003/v1/fb3d0b9e0950dd6aa2779846.png"},{"id":92529846,"identity":"f8341e27-42ab-4842-ae1c-c1b5dd36bd87","added_by":"auto","created_at":"2025-09-30 16:35:59","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":234383,"visible":true,"origin":"","legend":"\u003cp\u003eGeometric definition of the bone and the plate and screws. (A) Bone mesh obtained from the CT (B) Plate and screws modelled from the manufacturer's technical specifications and deformed to match the bone geometry. (C) Final assembly of bone, plate and screws.\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-7373003/v1/3e2d97bacfb5f1d75cf1f209.png"},{"id":92532359,"identity":"ce149b06-80c3-41f3-9add-55d2284cbe63","added_by":"auto","created_at":"2025-09-30 16:51:59","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":171402,"visible":true,"origin":"","legend":"\u003cp\u003eFaces selected to apply forces of hip joint model. (A) Faces selected in the distal epiphysis. (B) Faces selected in the proximal epiphysis.\u003c/p\u003e","description":"","filename":"6.png","url":"https://assets-eu.researchsquare.com/files/rs-7373003/v1/e05a476eba9aba48f1fc30bf.png"},{"id":92533606,"identity":"300b7dd2-6642-4192-917f-7cd7b88444d9","added_by":"auto","created_at":"2025-09-30 17:07:59","extension":"png","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":137725,"visible":true,"origin":"","legend":"\u003cp\u003eTransversal view of the assembly from the point of view of the gap. (A) Model B (B) Model C\u003c/p\u003e","description":"","filename":"7.png","url":"https://assets-eu.researchsquare.com/files/rs-7373003/v1/e100e8923c37323e9b6c039f.png"},{"id":92600493,"identity":"74323bd8-d794-40b5-80cf-e54c551bb417","added_by":"auto","created_at":"2025-10-01 14:23:42","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2164233,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7373003/v1/b82a9610-5df4-4cfe-a0ff-4def8eb05655.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Comparison of different plate constructs in a canine femoral gap fracture model: An “In-silico” biomechanical study","fulltext":[{"header":"Background","content":"\u003cp\u003eFemoral fractures account for 20\u0026ndash;25% of all fractures and 45% of long bone fractures. Diaphyseal fractures account for 56% of the total, with a significant proportion of them being comminuted\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. These types of fractures require stabilization systems under the concept of bridging osteosynthesis, a construct that increases the risk of implant failure due to working length plate increment and the absence of load-sharing between the main fragments\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e. These osteosynthesis systems are mechanically demanding, as they must withstand all loads and resist applied forces on the bone\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. Various stabilization strategies to \u0026ldquo;reinforce\u0026rdquo; bridge-plate constructs have been used over the years, including larger plate sizes, plate-rod fixation, double plating, orthogonal plating, dual bone fixation, and stack plating \u003csup\u003e\u003cspan additionalcitationids=\"CR3 CR4\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. Orthogonal locking plates have proven to be particularly useful in many types of comminuted fractures, and the femoral bone is one of the most representative examples of these constructs \u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eA bone, depending on each moment, is exposed to different forces. Similarly, in the event of a fracture, forces must be withstood by the implants with or without bone, as in the case of comminuted fractures. It is known, that osteosynthesis plate application on the bone tension surface acts as an interfragmentary tension band, while there is no bone defect on the contralateral side\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e, the situation presents in the bridging plates for comminuted fractures. Therefore, it is not clear if the ideal side for the plate application, thinking of its biomechanical behaviour in comminuted fractures, should be the tension or the compression bone surface. This is of particular interest in orthogonal plates, as in this case there is more freedom to apply a second plate on one or other surface.\u003c/p\u003e\u003cp\u003eIn the case of the canine femur, Sahar et al (2003)\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e described the stress and strain distribution, defining the lateral and cranial surfaces as tension surfaces and the caudal and medial surfaces as compression surfaces. In diaphyseal femoral fractures, plates are conventionally applied on the lateral bone surface. Assuming a mechanical weakness in comminuted fractures, orthogonal plates have been implemented among other constructions. In these cases, the second plate is usually applied on the cranial femoral surface, which is also considered the tension femoral surface\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e. However, limited studies have been performed evaluating this construct\u0026rsquo;s biomechanical behaviour and the possibility of other types of plate distribution.\u003c/p\u003e\u003cp\u003eOver time, different biomechanical studies have been carried out to assess the behaviour of implants and their application in long bone fractures, mainly \u0026ldquo;in vitro\u0026rdquo; tests. Currently, computational biomechanics provides tools to simulate the mechanical behaviour of anatomical regions and their implant interaction. In-silico analyses and their simulations have become valuable alternatives replacing, reducing, and refining experimental studies in animal and \u0026ldquo;in vitro\u0026rdquo; models. Thus, Three-dimensional finite element analysis (FEA) can determine the displacements, stresses, and strain on an implant, or complex fracture construction, under different applied forces\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eTo assess which orthogonal plate distribution would offer the best mechanical behaviour in a diaphyseal femoral gap fracture, the purpose of the present study was to evaluate the plate strain and construct stress distribution in two proposed orthogonal plate systems. The authors hypothesised that (1) the use of orthogonal plates provides superior biomechanical behaviour to the use of single plates, and (2) adding the second plate on the caudal femoral surface (compression side), instead of cranial (tension side), would show better mechanical behaviour in loading tests. For this, an in silico using the hip joint reaction force test was conducted.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eFigure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows the maximum stress produced in each model with respect to the applied load. Model C exhibits lower von Mises stress than Model B, which in turn exhibits lower stress than Model A for every compression load throughout the test. This indicates that under the same compression load, Model C produces less internal stress than the other models. In numerical terms, Model C achieves a Factor of Safety (FoS) 7.99 times larger than Model A and 1.72 times larger than Model B. Consequently, Model B achieves a FoS 4.62 times larger than Model A.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eFigure \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the stress distribution obtained through FEA. Model A exhibits a high concentration of stress on the area of the plate over the gap fracture, with negligible stress on the rest of the plate. Model B shows a more extended stress distribution, the maximum stress being on the lateral plate. Model C also shows a more extended stress distribution, the maximum stress being on the caudal plate.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe results support the first hypothesis. Orthogonal models demonstrated more robust mechanical properties compared to the single-plate system across all tests and variables. These findings align with previous studies, which indicate that orthogonal systems increase construct stiffness, load to failure, decrease plate strain and stress, and enhance implant fatigue life. These superior mechanical properties are attributed to greater area moment of inertia (AMI) and polar moment of inertia (PMI) compared to single plate constructs\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e. Therefore, orthogonal plates are recommended for use in bridging systems for comminuted fractures.\u003c/p\u003e\u003cp\u003eHighly comminuted fractures force implants to: (1) work with greater working lengths, and (2) support the totality of forces applied to the bone, as there is no contact between bone fragments \u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e. This results in an increased risk of implant fatigue and system failure. To compensate for these deficiencies, different strategies have been developed, the most common being the rod-plate, orthogonal, and parallel plates\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan additionalcitationids=\"CR13\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. The main advantages of double plate systems are minimizing the effect of the working length plate\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e, the possibility of being used in distal fractures with small fragments and allowing an increase in the number of screws in each fragment. The disadvantage is the need for more extensive surgical approaches, affecting the integrity of the soft tissue and bone. The use of locking plates and minimally invasive procedures can help to minimize these effects\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eIn clinical practice, the use of orthogonal plates in long bone fractures also seems to show advantages, with the presence of fewer post-surgical complications, although there are still few studies in veterinary medicine \u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eThe second hypothesis of this study was also confirmed. Placing the second plate on the femoral compressive side (caudal surface) resulted in lower stress and better fatigue resistance during compressive loading tests. Under axial compression, the maximal stress resisted by the three structural elements (bone, plate, and screws) was lower in the orthogonal system with lateral and caudal plates (Model C) compared to the orthogonal system with lateral and cranial plates (Model B). These results can be explained by the alignment of forces in the hip-joint reaction force model. According to femur anatomy, the line connecting both diaphysis centres is closer to the caudal face than to the cranial face\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e (see Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e and Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). This means the plate on the caudal face is more aligned with the load forces than the plate on the cranial face\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e. A more aligned plate reduces bending moments and thus the stress produced by them.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eThe FoS values obtained in this study further support the superiority of the orthogonal plate constructs. Model C achieved a FoS 7.99 times larger than Model A and 1.72 times larger than Model B, indicating significantly higher stability and resistance to failure. These values are notably large, which suggests that even if the specific values cannot be directly extrapolated to other individuals, Model C is likely to remain superior to Models B and A in terms of mechanical performance. Consequently, Model B also demonstrated a FoS 4.62 times larger than Model A, reinforcing the benefits of using orthogonal plates over single plate systems.\u003c/p\u003e\u003cp\u003eThe stress distribution results also highlight the advantages of Model C. In the compression simulations, Model C exhibited a more evenly distributed stress pattern across the caudal plate, reducing the concentration of stress at any single point. In Model A, the lateral plate is the sole component bearing all the stress, making it the primary load-bearing element. In Model B, the cranial plate supports the lateral plate, distributing the stress between them. However, in Model C, the caudal plate becomes the primary load-bearing element, with the lateral plate providing additional support. This shift in the primary load-bearing element to the caudal plate in Model C contributes to its superior mechanical performance and lower risk of implant failure. This is consistent with the earlier explanation of why Model C performs better under compressive loads. The central alignment of the caudal plate with the load forces means it attracts more stress, effectively distributing the load and reducing the risk of localized stress concentrations that could lead to implant failure\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan additionalcitationids=\"CR19 CR20\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eThis study has several limitations that should be acknowledged. Firstly, the \"in silico\" nature of the study assumes certain theoretical models and simplifications, such as linear elasticity and isotropy in the bone, and perfect bonding between the bone and screws, as well as between the plate and screws. Secondly, the geometric data was obtained from the femur of a single individual, which may not be representative of the broader canine population. Thirdly, the specific models tested, including the sizes of the plates and the number and positions of the screws, are relevant to the mechanical behaviour observed, and other configurations could yield different results. Despite these constraints, the authors propose the potential applicability of this model in future studies.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study evaluated the biomechanical performance of different orthogonal plate constructs in a canine femoral gap fracture model using in-silico analysis. Orthogonal plates, especially those with a caudal plate, demonstrated superior mechanical properties compared to single plate systems. The caudal plate configuration exhibited the highest factor of safety and the most evenly distributed stress pattern, making it the preferable choice for stabilizing comminuted femoral fractures.\u003c/p\u003e\u003cp\u003eThe caudal plate configuration offers better performance under compressive loads, potentially reducing post-surgical complications and improving implant longevity. Despite the study's limitations, the results support the potential applicability of these constructs in future studies and clinical practice.\u003c/p\u003e\u003cp\u003eIn conclusion, orthogonal plate constructs, particularly with a caudal plate, provide enhanced mechanical stability and are recommended for use in bridging systems for comminuted femoral fractures in canine patients.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003eGeometric definition:\u003c/h2\u003e\u003cp\u003eOn one hand, preparation of the geometric model for biomechanical simulation began with data extraction from computed tomography (CT) images using the software 3D Slicer (Version 5.4.0, \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.slicer.org/\u003c/span\u003e\u003cspan address=\"https://www.slicer.org/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e). The femoral bone of an eight-year-old neutered golden retriever, displaying no orthopaedic abnormalities, underwent scanning using a multidetector 16-slice Computed tomography scanner (Siemens Somatom Scope, Munich, Germany) in helical scan mode. The CT acquisition adhered to specific protocols and technique settings, including a 512 \u0026times; 512 matrix, a pitch of 0.8 with a scan thickness of 1.00 mm and operating at 170 mAs and 130 kV. The data processing consisted of isolating the bone of interest, cleaning of artifacts and other noise, and segmenting by bone density to differentiate and model cortical and trabecular bone independently. The resulting geometries were exported in three-dimensional mesh format, in this case (.OBJ), suitable for digital manipulation. On the other hand, the titanium plates and screws used in the bone fixation were modelled. This modelling is based on the manufacturer's technical specifications, respecting thickness, distance between holes, and all other dimensions. The fixation screws were simplified as cylinders for the numerical evaluation in accordance with the literature\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e. Since in clinical practice it is common to bend some plates prior to surgery to adapt them to the curvature of the bone, some of the plate models were bent using software to make the geometric definition as realistic as possible. This was done using Rhinoceros 3D software (Version 7, \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.rhino3d.com\u003c/span\u003e\u003cspan address=\"https://www.rhino3d.com\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eThe bone models and plates were then imported into ANSYS simulation software (Version 17, \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.ansys.com/\u003c/span\u003e\u003cspan address=\"https://www.ansys.com/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e). Using the SpaceClaim geometry manager, the plates were positioned at the required locations for each analysis. A 1.0mm gap fracture was simulated in the mild diaphysis, and Boolean operations were applied to model the interaction between the metal parts and the bone. Some preliminary simulations showed that the trabecular bone did not influence the stress distribution across the cortical bone and plate, so we removed it to simplify the output model. The resulting mesh consisted of about 130000 elements and 230000 nodes with a maximum edge size of 1.7 mm. Figure\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e shows the result of both parts and the final assembly.\u003c/p\u003e\u003cp\u003eMechanical definition:\u003c/p\u003e\u003cp\u003eThe FEA was executed in the Static Structural Analysis module, from the ANSYS simulation software. Both materials, bone and plate were defined using the elastic model with parameters shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The contact areas between the bone and the screws were defined as bonded. Anatomic loading areas were determined at the femur following the hip joint reaction force\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. Figure\u0026nbsp;\u003cspan refid=\"Fig6\" class=\"InternalRef\"\u003e6\u003c/span\u003e shows the faces selected for both surfaces. For the load conditions, the femoral head was defined as fixed support, and the external load was uniformly applied over the condylar surface. The maximum compression load was set as 1000 N. The loads were defined as linear transient from 0 to the maximum value.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eMechanical properties used in the simulation.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMaterial\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYoung\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eYield strength\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTitanium\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1e6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2e6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eExperiment design:\u003c/p\u003e\u003cp\u003eThree different construction methods were used in a gap fracture model of the femur:\u003c/p\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003eModel A: A single 12-hole lateral locking plate was used, fixed with 8 screws (6 in the central holes and 2 at the ends).\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eModel B: A 12-hole lateral locking plate and an 8-hole cranial locking plate were used. The lateral plate was fixed with 4 screws (2 in the central holes and 2 at the ends), and the cranial plate was fixed with 4 screws at the ends, ensuring no collisions.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eModel C: A 12-hole lateral locking plate and an 8-hole caudal locking plate were used. The lateral plate was fixed with 4 screws (2 in the central holes and 2 at the ends), and the caudal plate was fixed with 4 screws at the ends, ensuring no collisions.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003cp\u003eAll plates were fixed using 3.5 mm bi-cortical titanium locking screws. Figure\u0026nbsp;\u003cspan refid=\"Fig7\" class=\"InternalRef\"\u003e7\u003c/span\u003e shows the placement of the plates and screws.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eA compression tests was performed in each construction method. For each model, the most stressed point along the evolution of the external load is determined. For that point, the load (N) and stress (N/mm2) were determined. Results were obtained and compared between the three models.\u003c/p\u003e\u003c/div\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eFoS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003efactors of safety\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eFEA\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003efinite element analysis\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eAMI\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003earea moment of inertia\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003ePMI\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003epolar moment of inertia\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eCT\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003ecomputed tomography\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eN\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003enewtons\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cul\u003e\n \u003cli\u003eEthics approval and consent to participate: Not applicable.\u003c/li\u003e\n \u003cli\u003eConsent for publication: Not applicable.\u003c/li\u003e\n \u003cli\u003eAvailability of data and materials: The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/li\u003e\n \u003cli\u003eCompeting interest: The authors declare that they have no competing interests.\u003c/li\u003e\n \u003cli\u003eFunding: Publication fees will be paid by the Vice-Rectorate for Research at the Catholic University of Valencia.\u003c/li\u003e\n \u003cli\u003eAuthors´ Contributions: CIS was responsible for conceptualising the work, interpreting the data, and writing the paper; MI performed data acquisition and analysis, as well as reviewing the methodology section of the article; TS participated in the design of the work and data acquisition, CS participated in the study design, interpretation of results, and performed the final review of the work; LD participated in the conceptualisation and design of the study, was instrumental in interpreting the results, and participated in the final review of the work.\u003c/li\u003e\n \u003cli\u003eAcknowledgments: Not applicable\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eGuiot LP, D\u0026eacute;jardin LM. Chapter 60: Fractures of the femur. In: Spencer A. Johnston and Karen M. Tobias, editors. Veterinary Surgery Small Animal. 2nd Ed. Missouri (USA); Elsevier; \u0026nbsp;2018. p.1019-70.\u003c/li\u003e\n \u003cli\u003eDe Bruyne B, Glyde M, Day R, Hosgood G. Effect of orthogonal locking plate and primary plate working plate length on construct stiffness and plate strain in an in vitro fracture-gap model. Vet Comp Orthop Traumatol. 2024;37:173-80.\u003c/li\u003e\n \u003cli\u003eCraig A, Witte PG, Moody T, Harris K, Scott HW. Management of feline tibial diaphyseal fractures using orthogonal plates performed via minimally invasive osteosynthesis. Journal of Feline Medicine and Surgery. 2018;20(1):6-14.\u003c/li\u003e\n \u003cli\u003eField MR, Butler R, Wills RW, Maxwell WR. Retrospective evaluation of perioperative and short-term clinical outcomes in appendicular long bone skeleton fractures repaired via the string of pearls (SOP) locking plate system. BMC Veterinary Research. 2018;14:386-95.\u003c/li\u003e\n \u003cli\u003eTremolada G, Lewis DD, Paragnani KL, Conrad BP, Kim SE, Pozzi A. Biomechanical comparison of a 3.5-mm conical coupling plating system and a 3.5-mm locking compression plate applied as plate-rod constructs to an experimentally created fracture gap in femurs of canine cadavers. Am J Vet Res. 2017;78(6):712-7.\u003c/li\u003e\n \u003cli\u003eGlyde M, Day R, Deane B, Read R, Hosgood G. Biomechanical comparison of plate, plate-rod, and orthogonal plate locking constructs in an ex-vivo canine tibial fracture gap model. ECVS Congress, Ghent. July 2011.\u003c/li\u003e\n \u003cli\u003eMoreno MR, Zambrano S, D\u0026eacute;jardin LM, Saunders WB. Chapter 39: Bone biomechanics and fracture biology. In: Spencer A. Johnston and Karen M. Tobias, editors. Veterinary Surgery Small Animal. 2nd Ed. Missouri (USA); Elsevier; \u0026nbsp;2018. p.613-49.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eShahar R, Banks-Sills L, Eliasy R. Stress and strain distribution in the intact canine femur: finite element analysis. Med Eng Phys. 2003;25:387-95.\u003c/li\u003e\n \u003cli\u003eCarniel EL, Frigo A, Fontanella CG, De Benedictis GM, Rubini A, Barp L, Pluchino G, Sabbadini B, Polese L. A biomechanical approach to the analysis of methods and procedures of bariatric surgery. J Biomech. 2017;56:32-41.\u003c/li\u003e\n \u003cli\u003eCarniel EL, Toniolo I, Fontanella CG. Computational Biomechanics: In-Silico tools for the investigation of surgical procedures and devices. Bioengineering. 2020;7:48.\u003c/li\u003e\n \u003cli\u003eYamaguchi S, Anchieta RB, Guastaldi FPS, Tovar N, Tawara D, Imazato S, Coelho PG. In silico analysis of biomechanical stability of commercially pure Ti and Ti-15Mo plates for the treatment of mandibular angle fracture. J Oral Maxillofac Surg. 2017:1.e.1-9.\u003c/li\u003e\n \u003cli\u003eCheung ZB, Nasser P, Iatridis JC, Forsh DA. Orthogonal plating of distal femoral fractures: A biomechanical comparison with plate-nail and parallel plating constructs. J of Orthopedics. 2023;37:34-40.\u003c/li\u003e\n \u003cli\u003eKudo T, Hara A, Iwase H, Ichihara S, Nagao M, Murayama Y, Kaneko K. Biomechanical properties of orthogonal plate configuration using the same locking plate system for intra-articular distal humeral fractures under radial or ulnar column axial load. Injury. 2016;47(10):2071-6.\u003c/li\u003e\n \u003cli\u003eShih CA, Su WR, Lin WC, Tai TW. Parallel versus orthogonal plate osteosynthesis of adult distal humerus fractures: a meta-analysis of biomechanical studies. International Orthopaedics. 2019;43(2):449-60\u003c/li\u003e\n \u003cli\u003eRoe SC. Reducing plate strain with orthogonal plating. Vet Comp Orthop Traumatol. 2024;37:V-VI.\u003c/li\u003e\n \u003cli\u003eHiguchi M, Katayama M. Clinical outcomes of orthogonal plating to treat radial and ulnar fractures in toy-breed dogs. Journal of Small Animal Practice. 2021;62(11):1-6.\u003c/li\u003e\n \u003cli\u003eRenwick A, Scurrell E. Orthogonal bone plate stabilization for limb-sparing surgery. \u0026nbsp;Vet Comp Orthop Traumatol. 2013;26:505-9.\u003c/li\u003e\n \u003cli\u003eSchemitsch EH, Tencer AF, Henley MB. Biomechanical evaluation of methods of internal fixation of the distal humerus. J Orthop Trauma. 1994;8:468-75.\u003c/li\u003e\n \u003cli\u003eSchwartz A, Oka R, Odell T, Mahar A. Biomechanical comparison of two different periarticular plating systems for stabilization of complex distal humerus fractures. Clin Biomech. 2006;21:950-5.\u003c/li\u003e\n \u003cli\u003eTaylor PA, Owen JR, Benfield CP, Wayne JS, Boardman ND. Parallel plating of simulated distal humerus fractures demonstrates increased stiffness relative to orthogonal plating with a distal humerus locking plate system. J Orthop Trauma. 2016;30 e118-22.\u003c/li\u003e\n \u003cli\u003eMittag U, Kriechbaumer A, Rittweger J. Torsion \u0026ndash; An underestimated form shaping entity in bone adaptation? J Musculoskelet Neuronal Interact. 2018;18(4):407-18.\u003c/li\u003e\n \u003cli\u003eLang JJ, Li X, Micheler CM, Wilhelm NJ, Seidl F, Schwaiger BJ, et al.. Numerical evaluation of internal femur osteosynthesis based on a biomechanical model of the loading in the proximal equine hindlimb. BMC Vet Res. 2024; 20:188.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003e\u0026nbsp;Li J, Yin P, Zhang L, Chen H, Tang P. Medial anatomical buttress plate in treating displaced femoral neck fracture a finite element analysis. Injury. 2019;50(11):1895-900.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-veterinary-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [BMC Veterinary Research](http://bmcvetres.biomedcentral.com/)","snPcode":"12917","submissionUrl":"https://submission.nature.com/new-submission/12917/3?","title":"BMC Veterinary Research","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Canine, in silico, biomechanical analysis, femoral gap fracture, orthogonal plates","lastPublishedDoi":"10.21203/rs.3.rs-7373003/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7373003/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground: Femoral fractures are a common occurrence in canine patients, accounting for a significant proportion of long bone fractures. Diaphyseal fractures, particularly comminuted ones, pose a challenge due to the need for robust stabilization systems that can withstand various mechanical loads. Orthogonal plate constructs have been proposed as a solution, but their biomechanical behaviour in comminuted femoral fractures has not been extensively studied. This study aims to evaluate the mechanical performance of different orthogonal plate configurations in a canine femoral gap fracture model using in-silico biomechanical analysis.\u003c/p\u003e\n\u003cp\u003eResults: The study compared three models: a single lateral plate (Model A), a lateral plate with a cranial plate (Model B), and a lateral plate with a caudal plate (Model C). The results showed that Model C exhibited superior mechanical properties, including lower stress concentrations and higher factors of safety (FoS). Model C achieved a FoS 7.99 times larger than Model A and 1.72 times larger than Model B. The stress distribution analysis revealed that the caudal plate in Model C acted as the primary load-bearing element, effectively distributing the load and reducing the risk of implant failure. This was consistent with the alignment of the caudal plate with the load forces, which attracted more stress and minimized bending moments.\u003c/p\u003e\n\u003cp\u003eConclusions: Orthogonal plate constructs, particularly those with a caudal plate, provide enhanced mechanical stability in comminuted femoral fractures. The findings suggest that the caudal plate configuration offers better performance under compressive loads, making it a preferable choice for clinical applications. Despite the study's limitations, including the use of theoretical models and data from a single individual, the results support the potential applicability of these constructs in future studies and clinical practice.\u003c/p\u003e","manuscriptTitle":"Comparison of different plate constructs in a canine femoral gap fracture model: An “In-silico” biomechanical study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-30 16:35:54","doi":"10.21203/rs.3.rs-7373003/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-09-28T16:17:19+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"260277348151678311612112596139600968808","date":"2025-09-25T08:29:18+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"254377152429662171859140201395634440751","date":"2025-09-23T22:09:18+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-09-18T22:31:36+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-08-19T12:54:55+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-08-19T01:40:24+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-08-19T01:39:15+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Veterinary Research","date":"2025-08-14T10:38:57+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-veterinary-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [BMC Veterinary Research](http://bmcvetres.biomedcentral.com/)","snPcode":"12917","submissionUrl":"https://submission.nature.com/new-submission/12917/3?","title":"BMC Veterinary Research","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"304608d7-dcc4-42ab-86f0-93a57186485f","owner":[],"postedDate":"September 30th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-09-30T16:35:54+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-30 16:35:54","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7373003","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7373003","identity":"rs-7373003","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}