Determining how the pattern of bone healing affects the strain of plate implant via frequency detection: A biomechanical cadaveric study

Chavarin  Amarase; Chanyaphan  Virulsri; Pairat  Tangpornprasert; Pisitpong  Chancharoen; Saran  Tantavisut

Authors

Chavarin Amarase Biologics for Knee Osteoarthritis Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand andCenter of Excellence in Hip Fracture, Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Chanyaphan Virulsri Center of Excellence for Prosthetic and Orthopedic Implant, Chulalongkorn University, Bangkok, Thailand andBiomedical Engineering Research Center, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
Pairat Tangpornprasert Center of Excellence for Prosthetic and Orthopedic Implant, Chulalongkorn University, Bangkok, Thailand and Biomedical Engineering Research Center, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
Pisitpong Chancharoen Center of Excellence for Prosthetic and Orthopedic Implant, Chulalongkorn University, Bangkok, Thailand and Biomedical Engineering Research Center, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
Saran Tantavisut Center of Excellence in Hip Fracture, Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

Keywords:

Acoustic, bone healing, frequency, pattern, plate, strain, union

Abstract

Background: Detecting bone union is crucial in treating bone fractures to prevent complications, including implant failure and bone nonunion. To date, there are numerous methods and new innovative devices for detecting bone union via strain measurements, such as strain gauges, fluid level displacement, contrast media, and frequency changes. Moreover, there is a trend toward increasing these methods in the future. However, the patterns of bone healing studied with these methods do not provide a standard for determining the true bone healing process.

Objective: This study aimed to identify the most appropriate bone healing pattern for detecting bone healing using strain measurements via frequency changes.

Methods: Twenty cadaveric tibial bones were tested for five different bone healing patterns, including fractures with gap distances, material replacements, and healing from the outer side, inner side, and middle. Each healing pattern included four cadaveric bones evaluated under various axial loads of 100, 200, 300, and 400 N using an Instron ElectroPuls® E10000. Bone healing assessment employed bone union detection using a wire’s natural frequency plate to detect the strain change via frequency change.

Results: All bone healing patterns could evaluate bone union by comparing the frequency changes under axial loads of 100 and 400 N, with a mean difference of 32.4–39.8%. Only the fracture with gap distance and material replacement could be assessed gradually in each phase of healing (12.3% in gap of 2.5 mm, P < 0.01; 22.4% in gap of 5 mm, P = 0.04; 31.8% in gap of 7.5 mm, P = 0.005; 39.2% in gap of 10 mm, P = 0.004; and 11.0% in saw bone, P = 0.006; 19.5% in rubber, P < 0.001; 25.8% in foam, P < 0.001; 32.4% in fracture, P < 0.001).

Conclusions: The pattern of bone healing influences the assessment of bone union via the detection of strain changes. The methods involving gap distance and material replacement are the most suitable representation of normal bone healing.

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