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Author:

Fu Ruisen (Fu Ruisen.) | Feng Yili (Feng Yili.) | Liu Youjun (Liu Youjun.) (Scholars:刘有军) | Willie Bettina M (Willie Bettina M.) | Yang Haisheng (Yang Haisheng.)

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Scopus SCIE PubMed

Abstract:

Dynamization, increasing the interfragmentary movement (IFM) by reducing the fixation stiffness from a rigid to a more flexible condition, is widely used clinically to promote fracture healing. However, it remains unknown how dynamization degree (relative change in fixation stiffness/IFM from a rigid to a flexible fixation) affects bone healing at various stages. To address this issue, we used a fuzzy logic-based mechano-regulated tissue differentiation algorithm on published experimental data from a sheep osteotomy healing model. We applied a varied degree of dynamization, from 0 (fully rigid fixation) to 0.9 (90% reduction in stiffness relative to the rigid fixation) after 1, 2, 3, and 4 weeks of osteotomy (R1wF, R2wF, R3wF, and R4wF) and computationally evaluated bone regeneration and biomechanical integrity over the healing process of 8 weeks. Compared with the constant rigid fixation, early dynamization (R1wF and R2wF) led to delays in bone bridging and biomechanical recovery of the osteotomized bone. However, the effect of early dynamization on healing was dependent of the degree of dynamization. Specifically, a higher dynamization degree (e.g., 0.9 for R1wF) led to a prolonged delay in bone bridging and largely unrecovered bending stiffness (48% relative to the intact bone), whereas a moderate degree of dynamization (e.g., 0.5 or 0.7) significantly enhanced bone formation and biomechanical properties of the osteotomized bone. These results suggest that dynamization degree and timing interactively affect the healing process. A combination of early dynamization with a moderate degree could enhance the ultimate biomechanical recovery of the fractured bone.

Keyword:

fracture healing tissue differentiation dynamization finite element analysis interfragmentary movement

Author Community:

  • [ 1 ] [Fu Ruisen]Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
  • [ 2 ] [Feng Yili]Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
  • [ 3 ] [Liu Youjun]Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
  • [ 4 ] [Willie Bettina M]Department of Pediatric Surgery, Research Centre, Shriners Hospital for Children-Canada, McGill University, Montreal, Quebec, Canada
  • [ 5 ] [Yang Haisheng]Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China

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Source :

Journal of orthopaedic research : official publication of the Orthopaedic Research Society

ISSN: 1554-527X

Year: 2021

Cited Count:

WoS CC Cited Count: 0

SCOPUS Cited Count: 19

ESI Highly Cited Papers on the List: 0 Unfold All

WanFang Cited Count:

Chinese Cited Count:

30 Days PV: 9

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