Identification of screw spacing on pediatric hip locking plate in proximal femoral osteotomy

This study describes a computational analysis technique for evaluating the effect of screw spacing and angle on the pediatric hip locking plate system in proximal femoral osteotomy in pediatric patients having DDH with an aberrant femoral head and femoral angle. Under static compressive load conditions, the stresses of the screw and bone were examined as the screw spacing and angle changed. The spacing and angle of various screws were specifically considered as variables in this study based on the pile mechanism studied in civil engineering. As with the group pile mechanism, the tighter the screw spacing under static compressive loads, the more the overlapping effect between the bone stresses and the screws develops, increasing the risk of injuring the patient's bone. Therefore, a series of simulations was performed to determine the optimal screw spacing and angles to minimize the overlapping effect of bone stress. In addition, a formula for determining the minimum screw spacing was proposed based on the computational simulation results. Finally, if the outcomes of this study are applied to pediatric patients with DDH in the pre-proximal femoral osteotomy stage, post-operative load-induced femur damage will be reduced.