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RESEARCH ARTICLE

Generative design of patient-specific bone plates for Schatzker type VI tibial plateau fractures

Weiting Xu1 ,  Xiaoqiang Zheng2 ,  Yan Xu1 ,  Rixiang Quan1 ,  Yi Huang1 ,  Weiqiang Li3 ,  Cian Vyas4 ,  Paulo Bartolo4,5 ,  Di Wang2 ,  Fengyuan Liu1∗
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1 School of Electrical, Electronic, and Mechanical Engineering, University of Bristol, Bristol, United Kingdom
2 School of Mechanical & Automotive Engineering, South China University of Technology, Guangzhou, Guangdong, China
3 Shenzhen Jinshi 3D Printing Technology Co., Ltd., Shenzhen, Guangdong, China
4 Singapore Centre for 3D Printing, Nanyang Technological University, Singapore
5 School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore
IJB, 025400410 https://doi.org/10.36922/IJB025400410
Received: 2 October 2025 | Accepted: 4 November 2025 | Published online: 4 November 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Schatzker type VI fractures are complex tibial plateau injuries characterized by multiple fracture lines and complete separation between the plateau and the shaft. These features reduce the effectiveness of standard commercial fixation plates, which often fail to conform to the irregular anatomy. Patient-specific plates, tailored to individual bone geometry, offer improved anatomical fit and fixation. This study aims to compare two patient-specific designs, based on 3D reconstruction (3DP) and generative design (GDP), with a conventional commercial plate (CP). To enable rapid and costeffective evaluation, all designs were first prototyped in poly(lactic acid) using fused deposition modeling. In bending tests, both 3DP and GDP were significantly stiffer than CP, with stiffness increases of 23.8% and 10.0%, respectively. In biomechanical compression tests, both patient-specific designs exhibited approximately 15% lower displacement than CP under a 750 N load. Based on these results, the GDP design was selected for metal additive manufacturing using laser powder bed fusion. The metal printed GDP was tested under a compressive load of 750 N and showed a mean displacement of 2.11 ± 0.01 mm, remaining below the commonly accepted clinical threshold of 3 mm. This work highlights the potential of combining PLA-based prototyping with targeted metal validation to support surgical decision-making and streamline implant development.

Graphical abstract
Keywords
3D printing
Generative design
Patient-specific bone plate
Schatzker type VI fractures
Funding
This work was supported by the China Scholarship Council (Project No. 202208060391) and by the United Kingdom Research and Innovation Oversea Travel Grant (UKRI2858).
Conflict of interest
Paulo Bartolo and Fengyuan Liu are members of the Editorial Board of this journal but were not involved, directly or indirectly, in the editorial or peer-review process for this article. The other authors declare that they have no competing interests.
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International Journal of Bioprinting, Electronic ISSN: 2424-8002 Print ISSN: 2424-7723, Published by AccScience Publishing
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