JCCVS
Journal of Cardiology & Cardiovascular Surgery

Journal of Cardiology & Cardiovascular Surgery scientific, open-access, double-blind peer-reviewed journal covering a wide spectrum of topics in cardiology and cardiovascular surgery.

eISSN: 2980-1397
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Original Article
Biomechanical comparison of commercially pure titanium and Ti-6Al-4V grade 5 sternal plates under static and dynamic loading conditions
Abstract
Aims: Secure sternal fixation following median sternotomy is essential to prevent postoperative complications such as pain, respiratory dysfunction, sternal dehiscence, and mediastinitis. While Ti-6Al-4V Grade 5 titanium is widely used due to its high static strength, its excessive rigidity and limited ductility may compromise anatomical adaptation and fatigue performance. Commercially pure (CP) titanium, with mechanical properties closer to 316L stainless steel, may offer improved ductility without sacrificing fixation stability. This study aimed to compare the biomechanical behavior of CP titanium and Ti-6Al-4V Grade 5 sternal plates under static and dynamic loading conditions simulating physiological respiratory forces.
Methods: Straight, six-hole locked sternal plates manufactured from CP titanium (Grade 2/4) and Grade 5 titanium were evaluated. Static three-point bending tests and dynamic fatigue tests were performed using an Instron universal testing machine. A peak load of 250 N was applied to simulate clinically relevant sternal dehiscence forces, followed by cyclic loading up to 1,000,000 cycles at physiological frequencies. Load–displacement behavior, yield strength, displacement, and failure modes were analyzed and statistically compared.
Results: All constructs demonstrated plastic deformation without screw loosening, pull-out, or screw fracture. Catastrophic plate failure occurred exclusively in Grade 5 titanium plates, characterized by a shorter plastic deformation phase and abrupt fracture at the screw hole adjacent to the bending zone. In contrast, CP titanium plates exhibited prolonged plastic deformation without catastrophic failure under the same loading conditions. After 1 million fatigue cycles at 250 N, both materials maintained construct integrity, with no statistically significant difference in post-fatigue displacement (P > 0.05).
Conclusion: CP titanium sternal plates provide biomechanical performance comparable to Grade 5 titanium under clinically relevant static and dynamic loads while offering superior ductility and anatomical adaptability. These findings suggest that CP titanium represents a safe and clinically advantageous alternative to Grade 5 titanium for sternal fixation, particularly in anatomically complex and dynamically loaded environments.

Keywords : Sternotomy, sternal fixation, commercially pure titanium, Ti-6Al-4V, fatigue testing, biomechanics, locked plate system

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Article available in :
Volume 4, Issue 1, 2026
Page : 1-5
https://doi.org/10.51271/JCCVS-0068
Article Information
Received : 19 Kas 2025
Accepted : 19 Ara 2025
Published : 28 Mar 2026
Corresponding Author :

Mehmet Kabalcı: Department of Cardiovascular Surgery, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkiye

[email protected]
Citation : Kabalcı M. Biomechanical comparison of commercially pure titanium and Ti-6Al-4V grade 5 sternal plates under static and dynamic loading conditions. J Cardiol Cardiovasc Surg. 2026;4(1):1-5. doi:10.51271/JCCVS-0068

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