scholarly journals A Novel Capacitive Measurement Device for Longitudinal Monitoring of Bone Fracture Healing

Sensors ◽  
2021 ◽  
Vol 21 (19) ◽  
pp. 6694
Author(s):  
Angela Sorriento ◽  
Marcello Chiurazzi ◽  
Luca Fabbri ◽  
Michelangelo Scaglione ◽  
Paolo Dario ◽  
...  
Keyword(s):  
Bone Fractures ◽  
Healing Process ◽  
Long Bone ◽  
Sensor Technology ◽  
External Fixators ◽  
X Rays ◽  
Implant Stability ◽  
Measurement Device ◽  
3D Space ◽  
Bone Callus

The healing process of surgically-stabilised long bone fractures depends on two main factors: (a) the assessment of implant stability, and (b) the knowledge of bone callus stiffness. Currently, X-rays are the main diagnostic tool used for the assessment of bone fractures. However, they are considered unsafe, and the interpretation of the clinical results is highly subjective, depending on the clinician’s experience. Hence, there is the need for objective, non-invasive and repeatable methods to allow a longitudinal assessment of implant stability and bone callus stiffness. In this work, we propose a compact and scalable system, based on capacitive sensor technology, able to measure, quantitatively, the relative pins displacements in bone fractures treated with external fixators. The measurement device proved to be easily integrable with the external fixator pins. Smart arrangements of the sensor units were exploited to discriminate relative movements of the external pins in the 3D space with a resolution of 0.5 mm and 0.5°. The proposed capacitive technology was able to detect all of the expected movements of the external pins in the 3D space, providing information on implant stability and bone callus stiffness.

scholarly journals The Effect of External Fixator Configurations on the Dynamic Compression Load: An Experimental and Numerical Study

2019 ◽  
Vol 10 (1) ◽  
pp. 3
Author(s):  
Ana Martins Amaro ◽  
Maria Fátima Paulino ◽  
Luis Manuel Roseiro ◽  
Maria Augusta Neto
Keyword(s):  
External Fixator ◽  
Bone Fractures ◽  
Numerical Study ◽  
Dynamic Compression ◽  
Healing Process ◽  
Laminated Composite ◽  
Composite Plates ◽  
External Fixators ◽  
Compression Load ◽  
Bone Callus

(1) Objective: External fixation systems are commonly used by surgeons to ensure stabilization and consolidation of bone fractures, especially in patients who are at high risk for systematic complications. Both rigid and elastic external fixations are important in the fracture healing process. This study aims to evaluate the behavior of the Orthofix Limb Reconstruction System (LRS)® in the dynamic compression mode. (2) Methods: Experimental and numerical setups were developed using a simplified model of a human tibia which consisted of a nylon bar with a diameter of 30 mm. The bone callus was included in both setups by means of a load cell-based system, which consisted of two carbon epoxy laminated composite plates with a final stiffness of 220 N/mm. The system was evaluated experimentally and numerically, considering different numbers of pins and comparing distances between the external fixator frame and the bone, achieving a good correlation between experimental and numerical results. (3) Results: The results identified and quantified the percental load transferred to the fracture and its sensibility to the distance between the external fixator and bone. Additionally, LRS locking stiffness was evaluated which resulted from the clamp-rail clearances. The results show that the blocking effects of the free clamp movement are directly related to the fixator configuration and are responsible for changes in the amount of load that crosses the bone callus. (4) Conclusions: From the biomechanical point of view, the results suggest that the average bending span of Schanz pins and the weights of the patients should be included into clinical studies of external fixators comparisons purpose.

scholarly journals Influence of different methods of internal bone fixation on characteristics of bone callus in experimental animals

2014 ◽  
Vol 142 (1-2) ◽  
pp. 40-47
Author(s):  
Djordje Gajdobranski ◽  
Milorad Mitkovic ◽  
Nada Vuckovic ◽  
Miroslav Milankov ◽  
Slobodan Jovanovic ◽  
...  
Keyword(s):  
Bone Fractures ◽  
Plate Fixation ◽  
Stress Test ◽  
Statistical Significance ◽  
Healing Process ◽  
Biomechanical Testing ◽  
Long Bone ◽  
Femoral Diaphysis ◽  
Experimental Animals ◽  
Bone Callus

Introduction. Correct choice of osteosynthesis method is a very important factor in providing the optimal conditions for appropriate healing of the fracture. There are still disagreements about the method of stabilization of some long bone fractures. Critically observed, no method of fracture fixation is ideal. Each osteosynthesis method has both advantages and weaknesses. Objective. The objective of this study was to compare the results of the experimental application of three different internal fixation methods: plate fixation, intramedullary nail fixation and self-dynamisable internal fixator (SIF). Methods. A series of 30 animals were used (Lepus cuniculus) as experimental animals, divided into three groups of ten animals each. Femoral diaphysis of each animal was osteotomized and fixed with one of three implants. Ten weeks later all animals were sacrificed and each specimen underwent histological and biomechanical testing. Results. Histology showed that the healing process with SIF was more complete and bone callus was more mature in comparison to other two methods. During biomechanical investigation (computerized bending stress test), it was documented with high statistical significance that using SIF led to stronger healing ten weeks after the operation. Conclusion. According to the results obtained in this study, it can be concluded that SIF is a suitable method for fracture treatment.

scholarly journals Optimization of a Patient-Specific External Fixation Device for Lower Limb Injuries

Polymers ◽  
2021 ◽  
Vol 13 (16) ◽  
pp. 2661
Author(s):  
Mohammed S. Alqahtani ◽  
Abdulsalam Abdulaziz Al-Tamimi ◽  
Mohamed H. Hassan ◽  
Fengyuan Liu ◽  
Paulo Bartolo
Keyword(s):  
Topology Optimization ◽  
External Fixation ◽  
Polylactic Acid ◽  
External Fixator ◽  
Bone Fractures ◽  
Healing Process ◽  
Patient Specific ◽  
External Fixators ◽  
Fixation Devices ◽  
Limb Injuries

The use of external fixation devices is considered a valuable approach for the treatment of bone fractures, providing proper alignment to fractured fragments and maintaining fracture stability during the healing process. The need for external fixation devices has increased due to an aging population and increased trauma incidents. The design and fabrication of external fixations are major challenges since the shape and size of the defect vary, as well as the geometry of the human limb. This requires fully personalized external fixators to improve its fit and functionality. This paper presents a methodology to design personalized lightweight external fixator devices for additive manufacturing. This methodology comprises data acquisition, Computer tomography (CT) imaging analysis and processing, Computer Aided Design (CAD) modelling and two methods (imposed predefined patterns and topology optimization) to reduce the weight of the device. Finite element analysis with full factorial design of experiments were used to determine the optimal combination of designs (topology optimization and predefined patterns), materials (polylactic acid, acrylonitrile butadiene styrene, and polyamide) and thickness (3, 4, 5 and 6 mm) to maximize the strength and stiffness of the fixator, while minimizing its weight. The optimal parameters were found to correspond to an external fixator device optimized by topology optimization, made in polylactic acid with 4 mm thickness.

scholarly journals Correlating mRUST scoring with fracture healing in the mouse model

2020 ◽  
Vol 3 ◽  
Author(s):  
Anthony McGuire ◽  
Adam Knox ◽  
Caio de Andrade Staut ◽  
Melissa Kacena ◽  
Roman Natoli ◽  
...  
Keyword(s):  
Mouse Model ◽  
Fracture Healing ◽  
Bone Fractures ◽  
Healing Process ◽  
Fracture Repair ◽  
Long Bone ◽  
Post Surgery ◽  
Method Of Assessment ◽  
Non Destructive

Background/Objective: Long bone fractures are an expensive and frequent cause of disability in humans. Research seeking to accelerate and improve the healing process is more essential than ever. Animal models, mice especially, provide an inexpensive and reproducible model of in vivo fracture healing. However, many measures of murine fracture healing outcomes are either expensive or destructive, limiting their ability to be translated to clinical studies. We seek to determine how these measures such as biomechanics, µCT, and histology correlate to the relatively new, inexpensive, and non-destructive method of mRUST scoring in a mouse model.  Methods: One hundred and thirty-five, 12-week old male C57BL6/J mice were divided into nine groups of 15 mice. Mice underwent a surgically created, femoral fracture. At biweekly timepoints, anteroposterior and lateral radiographs were taken, and 15 mice were sacrificed at each time point (7, 10, 14, 17, 21, 24, 28, 35, and 42 days post-surgery) for biomechanical, µCT, and histological analyses. The modified Radiographic Union Scale for Tibial fractures (mRUST scoring) provides a score based on the visualization of a callus and fracture line in four cortices on the radiographs. Data analysis will be performed to determine the degree of correlation between mRUST scoring and other fracture healing outcomes.  Results/Conclusion: Data collection in this experiment is still forthcoming. Upon successful completion of this project, we will have established numerical correlations between mRUST scoring and other fracture healing outcomes, such as biomechanics, µCT microarchitecture, and histology. These correlations will provide a powerful tool in future mouse fracture healing studies, as data on the state and strength of fracture repair could be determined by simple radiograph.  Scientific/Clinical Policy Impact and Implications: This study will both provide future murine fracture studies with an inexpensive and non-destructive method of assessment that is more directly translatable to human fracture studies. 

scholarly journals Modified deep learning ResNeXt model for Human long bone fracture detection and classification

2021 ◽  
Author(s):  
Ashish Sharma ◽  
◽  
D. P. Yadav ◽  
Keyword(s):  
Machine Learning ◽  
Deep Learning ◽  
Bone Fractures ◽  
Healing Process ◽  
Medical Science ◽  
Texture Features ◽  
Long Bone ◽  
Fracture Detection ◽  
X Ray Imaging ◽  
Automated Technique

The field of medical science is going to take advantage of Machine learning. It has increased dramatically over the last decade. Nowadays, you can see other innovations used in medical sciences, such as machine learning and deep learning. They can help to diagnose the illness or cause. It can also aid in the healing process by keeping notes. At a similar pace, an upper hand has been provided to the physicians for image processing by incorporating computers. Bone fractures are normal these days, and the identification of fractures is a critical part of orthopedic X-ray imaging. The automated technique lets the doctor quickly begin medical treatment. Using Machine Learning and CNN (Convolutional Neural Network), we suggest a new deep learning model perform bone diagnosis by eliminating discontinuity followed by segmentation of the image in a system that detects bone fractures. It overcomes the shortcomings of the previous approach that operates only on examination of the texture features. The proposed deep learning modified ResNeXt model performs much better than the state-of arts.

scholarly journals Epoxy putty external skeletal fixation in a tibiotarsal fracture of a wild choroy parakeet (Enicognathus leptorhynchus)

2015 ◽  
Vol 67 (3) ◽  
pp. 671-678 ◽  
Author(s):  
J. I. Arias ◽  
C. Beato ◽  
A. Espinoza
Keyword(s):  
Ex Vivo ◽  
Weight Bearing ◽  
External Fixators ◽  
X Rays ◽  
Bone Necrosis ◽  
Cerclage Wire ◽  
Epoxy Material ◽  
Bone Callus ◽  
Primary Bone ◽  
Transverse Fractures

Tibiotarsal fractures are common in birds because in most birds this is the longest, most exposed bone in the leg. Transverse fractures are most common and rotational and shear forces must be stabilized in order to achieve good bone regeneration. A 230g male Slender-billed Parakeet or Choroy parakeet (Enicognathus leptorhynchus), with more than five years of age, was received with non-weight bearing lameness with 24 hours duration. X-rays were taken, and these revealed a closed, complete, non-comminuted transverse fracture of the distal diaphysis of the left tibiotarsal bone. Fixation was planned with 10-minute fast-setting epoxy putty. In order to assess the temperature of polymerization of the epoxy dough and the possibility of heat-bone necrosis, the temperature was recorded every 30 seconds for 12 minutes with three different amounts of the epoxy material in an ex vivo test. The temperature of the pieces reached a peak of 50-60ºC, where the highest peak corresponds to the highest amount of material. When approximately 6g of putty were used, the peak temperature reached only 51ºC. This peak changed to 58ºC when 4 times more epoxy was mixed and measured. If the temperature of the pins inserted in the bone exceeds 70ºC, bone necrosis could occur. In light of these results, the fracture was treated with 6 g of epoxy putty that was allowed to polymerize over a 1A 2/2 external skeletal fixation, with 1-mm pins bent at 90º and joined together with cerclage wire. At 6 weeks after surgery the bird had formed a good primary bone callus, and the external fixators were therefore removed. With this approach a satisfactory recovery of the patient was achieved with normal use of the affected limb.

Repeat radiographic imaging in patients with long bone fractures transferred to a pediatric trauma center

2018 ◽  
Vol 67 (1) ◽  
pp. 59-62
Author(s):  
Courtney W Mangus ◽  
Bruce L Klein ◽  
Marlene Miller ◽  
Dylan Stewart ◽  
Leticia M Ryan
Keyword(s):  
Trauma Center ◽  
Bone Fractures ◽  
Diagnostic Yield ◽  
Pediatric Trauma ◽  
Long Bone ◽  
X Rays ◽  
Radiographic Imaging ◽  
Long Bone Fractures ◽  
Repeat Imaging ◽  
Pediatric Trauma Center

This study sought to determine the proportion of children with long bone fractures who undergo duplicate radiographic imaging after transfer to a pediatric trauma center (PTC) for further management. The secondary objective was to explore provider rationale and diagnostic yield of repeat X-rays. This was a single-site, retrospective cohort study conducted at a PTC. All patients, aged 0–21 years, who were transferred to the PTC for management of a long bone fracture were included. Electronic medical records were reviewed to determine the proportion of children who had repeat radiographic imaging and the provider rationale for obtaining this. T-test and Χ2 analyses were used to compare patients who had repeat X-rays with those who did not. During the study period, 309 patients (63% male, mean age 7.2±4.3 years) were transferred from 30 referring hospitals. Of these, 43% (n=133) underwent repeat radiographs. Patient age (p=0.9), gender (p=0.7), fracture location (p=0.19), and type of referring emergency department (pediatric vs general, p=0.3) were not significantly associated with repeat imaging. Rationale for repeat imaging could be ascertained in 31% of cases (n=41); the most common reasons were request by orthopedist (17%, n=23) and suboptimal original imaging (10%, n=13). Repeat imaging at the PTC did not reveal new or additional diagnoses in any case. Nearly half of the children in our study population undergo repeat and likely unnecessary imaging. Strategies to reduce repeat radiographs should be developed, as redundant imaging exposes patients to additional radiation and increases medical expense.

Effect of xenogenic cortical bone on fracture healing in a canine fracture model

2013 ◽  
Vol 61 (2) ◽  
pp. 149-159
Author(s):  
Suyoung Heo ◽  
Kyoungmin So ◽  
Sehoon Kim ◽  
Minsu Kim ◽  
Haebeom Lee ◽  
...  
Keyword(s):  
Cortical Bone ◽  
Bone Healing ◽  
Bone Fractures ◽  
Healing Process ◽  
Fracture Repair ◽  
Host Bone ◽  
Long Bone ◽  
Micro Ct ◽  
Group A ◽  
Group B

The purpose of this study was to investigate the effect of xenogenic cortical bone (XCB) on fracture repair in the canine ulna. The entire group of animals (n = 12) had a transverse resection of 5 mm length at the middle part of the right ulnar diaphysis. In Group A (eight beagles), the fracture was treated with XCB and metal bone screw. In Group B (four beagles), the fracture was treated with metal bone plate and screw. Radiological, micro-computed tomography (micro-CT), histological examination and mechanical testing were employed to evaluate bone healing and reaction of XCB in the host bone. In Group A, bone union was noticed in 6 out of 8 dogs (75%), starting from the 4th week onwards. Micro-CT and histological examinations showed that the XCB was absorbed and incorporated into the host bone. Incorporation of XCB was observed in 7 cases (88%); it started from the 10th week onwards and continued to week 32 after surgery. Biomechanical strength of the bone fracture site was higher in Group A than in Group B, and was similar to that of normal bone. XCB enhances the bone healing process and can be used as absorbable internal fixation for the management of long bone fractures in dogs.

scholarly journals Analysis of results of nonunion tibial fractures Ilizarov external fixation

2018 ◽  
Vol 4 (5) ◽  
pp. 698 ◽  
Author(s):  
Pandillapalli Devanatha Reddy ◽  
Koramutla Harsha Kumar
Keyword(s):  
Bone Fractures ◽  
Bone Transport ◽  
The Body ◽  
Long Bone ◽  
External Fixators ◽  
Average Hospital ◽  
Non Union ◽  
Long Bone Fractures ◽  
Consolidation Phase ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> Tibia is most exposed bone in the body and vulnerable to trauma and therefore its fractures are common among the long bone fractures. Tibia is the common site of non-union in long bone fractures. Management of non-union in long bone fractures is a challenging problem for orthopedic surgeons. When the defect is more than 4 cm then it needs bone transport.</p><p class="abstract"><strong>Methods:</strong> Materials of this study comprised 20 cases of nonunions of tibia treated over 2½ years period from June 2006 to December 2009 in the Department of Orthopedics at Narayana Medical College, Nellore, Andhra Pradesh. This was a prospective study of nonunions of tibia treated by Ilizarov ring external fixators and incidental surgery.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 20 tibial non-unions, in 15 patients the fixator has been removed. In 4 patients the fracture had united but the fixators are in situ and they are in consolidation phase and the remaining 1 patient is in various stage of follow up. The results of the 15 patients in whom the fixators have been removed are studied. The hospitalization time from 15 days to 120 days. The average hospital duration is 44.04 days. The total time ranged from 4 months to 15 months. Average time is 9.25 months.</p><p class="abstract"><strong>Conclusions:</strong> From this study we conclude that Ilizarov external fixator is a reliable, versatile and effective treatment for the treatment of tibia nonunion fractures.</p>

FEA Analysis of a Portable Knee Rehabilitation Device Using Mechanical Loading

2012 ◽  
Author(s):  
Daric Fitzwater ◽  
Andrew Rophie ◽  
Benjamin Schroeder ◽  
Andrew Dole ◽  
Juan Solano ◽  
...  
Keyword(s):  
Bone Fractures ◽  
Healing Process ◽  
Long Bone ◽  
The Finite Element Method ◽  
Engineering Research ◽  
Knee Rehabilitation ◽  
Research Initiative ◽  
Knee Loading ◽  
Fea Analysis ◽  
Ansys Workbench

In this paper, a solid model has been created with CAD software and analyzed with FEA software to obtain the deformed geometry, stress distribution, modal frequencies, temperature distribution, and life expectancy of a knee loading device that will be used in a combined biomedical and mechanical engineering research initiative. The purpose of this device is to mechanically load the end of the long bone of the human leg, causing movement of the fluids within the bone that can stimulate increased growth of bone tissues. This could potentially be used to speed the healing process of bone fractures. The CAD model of the device was constructed in Pro/ENGINEER and then exported to ANSYS Workbench where it was then meshed and solved using the finite element method.

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