Influence of fracture geometry on bone healing under locking plate fixations: A comparison between oblique and transverse tibial fractures

Saeed Miramini, Lihai Zhang, Martin Richardson, Priyan Mendis, Peter R. Ebeling

Research output: Contribution to journalArticleResearchpeer-review

45 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1100-1108
Number of pages9
JournalMedical Engineering and Physics
Volume38
Issue number10
DOIs
Publication statusPublished - 1 Oct 2016

Keywords

  • Bone fracture healing
  • Cell differentiation
  • Computational modelling
  • Interfragmentary movement
  • Mechanical testing
  • Oblique fracture

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