Abstract
This study aimed to evaluate the mechanical performance of CF/PEEK composite plates for external fixation through finite element analysis (FEA), and to explore the impact of different screw placement patterns on fixation stability. A proximal tibial fracture model treated with external fixation was constructed using FEA. Longitudinal loading was applied to simulate walking stress, with additional internal and external rotational torques to mimic load-bearing movement. Mechanical responses of titanium alloy and CF/PEEK plates were compared under three loading conditions: longitudinal, longitudinal with internal rotation, and longitudinal with external rotation. Screw alignment was also varied between linear and non-linear configurations to assess its biomechanical influence. Compared to titanium alloy group, the linear CF/PEEK plate exhibited a mild increase in displacement of 0.232–0.386 mm (8.23–11.14%), accompanied by a substantial reduction in plate stress of 46.03–80.84%. At the fracture site, interfragmentary displacement increased slightly by 0.105–0.132 mm (5.56–6.74%), while fracture-site stress increased by 3.119–18.029 MPa (18.30–63.20%). The non-linear CF/PEEK plate demonstrated a similar biomechanical performance, with no significant differences compared with the linear configuration. For external plate fixation, CF/PEEK represents a promising alternative to conventional titanium alloy plates. By allowing an acceptable level of local micromotion, CF/PEEK plates significantly reduce stress in the plate and screws while increasing stress transfer at the fracture site. This load-sharing behavior may mitigate stress shielding associated with traditional metallic plates and thereby promote early biological fracture healing.
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The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.
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Funding
Supported by the Agricultural and Social Development Science and Technology Project of Yinzhou District, Ningbo City (2020AS0034); Ningbo No.6 Hospital Science and Technology Program (2023002); Ningbo Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation (2024L004).
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S.W. and Z.Z. wrote the manuscript text. L.A., N.N. and J.Z. constructed the finite element models and performed the simulations. Q.Y. analyzed the data and assisted with figure preparation. J.C. supervised the project and revised the manuscript. All authors reviewed and approved the final manuscript.
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Wang, S., Zhao, Z., An, L. et al. Biomechanical evaluation of X-ray permeable CF/PEEK composite versus conventional titanium alloy for tibial external fixation plates: a finite element analysis. Sci Rep (2026). https://doi.org/10.1038/s41598-026-43182-8
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DOI: https://doi.org/10.1038/s41598-026-43182-8
