Biomechanical Fracture Thresholds of the Tibia and Fibula Under Axial and Multi-axial Loading: A Systematic Review

Area of Science:

• Biomechanics
• Orthopedics
• Trauma Research

Background:

• Understanding lower-limb fracture mechanics is crucial for injury prediction and orthopedic device design.
• Existing biomechanical data on tibia and fibula fracture thresholds under various loading conditions is synthesized.

Purpose of the Study:

• To systematically review and synthesize evidence on the biomechanical fracture thresholds of the tibia and fibula.
• To establish clinically relevant benchmarks for injury prediction and orthopedic device development.

Main Methods:

• Systematic literature search of PubMed, Embase, Scopus, and Cochrane Library.
• Inclusion of six studies: cadaveric, computational, and material testing investigations.
• Analysis of 72 postmortem specimens and validated finite element models.

Main Results:

• Tibial fracture thresholds vary from approximately 7.5 kN (female specimens) to 11.3 kN (combined axial/bending loads).
• Fibula contribution enhances axial tolerance by about 10%.
• Multi-axial loading consistently decreased fracture tolerance compared to axial loading alone.

Conclusions:

• Fracture resistance is influenced by specimen gender, load duration, and methodology.
• Multi-axial loading assessment is critical for accurate lower-limb fracture mechanics understanding.
• Findings offer benchmarks for injury prediction, preclinical testing, and orthopedic device design.