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Title: Influence of fracture geometry on bone healing under locking plate fixations: A comparison between oblique and transverse tibial fractures.
Epworth Authors: Richardson, Martin
Other Authors: Miramini, Saeed
Zhang, Lihai
Mendis, Priyan
Ebeling, Peter
Keywords: Bone Fracture Healing
Cell Differentiation
Computational Modelling
Interfragmentary Movement
Mechanical Testing
Oblique Fracture
Angle of Obliquity
Callus Strain
Interstitial Fluid Flow
Musculoskeletal Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Jul-2016
Publisher: Elsevier
Citation: Med Eng Phys. 2016 Jul 27. pii: S1350-4533(16)30155-2
Abstract: Mechano-regulation plays a crucial role in bone healing and involves complex cellular events. In this study, we investigate the change of mechanical microenvironment of stem cells within early fracture callus as a result of the change of fracture obliquity, gap size and fixation configuration using mechanical testing in conjunction with computational modelling. The research outcomes show that angle of obliquity (θ) has significant effects on interfragmentary movement (IFM) which influences mechanical microenvironment of the callus cells. Axial IFM at near cortex of fracture decreases with θ, while shear IFM significantly increases with θ. While a large θ can increase shear IFM by four-fold compared to transverse fracture, it also result in the tension-stress effect at near cortex of fracture callus. In addition, mechanical stimuli for cell differentiation within the callus are found to be strongly negatively correlated to angle of obliquity and gap size. It is also shown that a relatively flexible fixation could enhance callus formation in presence of a large gap but could lead to excessive callus strain and interstitial fluid flow when a small transverse fracture gap is present. In conclusion, there appears to be an optimal fixation configuration for a given angle of obliquity and gap size.
DOI: 10.1016/j.medengphy.2016.07.007
PubMed URL:
ISSN: 1350-4533
Journal Title: Medical Engineering & Physics
Type: Journal Article
Affiliated Organisations: Department of Infrastructure Engineering, The University of Melbourne, Victoria 3010, Australia
Department of Medicine, School of Clinical Sciences, Monash University, Monash Medical Centre, Victoria 3168, Australia
Type of Clinical Study or Trial: Cohort Study
Appears in Collections:Musculoskeletal

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