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Author:

Fu, Ruisen (Fu, Ruisen.) | Feng, Yili (Feng, Yili.) | Liu, Youjun (Liu, Youjun.) | Willie, Bettina M. (Willie, Bettina M..) | Yang, Haisheng (Yang, Haisheng.)

Indexed by:

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:

interfragmentary movement tissue differentiation dynamization fracture healing finite element analysis

Author Community:

  • [ 1 ] [Fu, Ruisen]Beijing Univ Technol, Fac Environm & Life, Dept Biomed Engn, 100 Pingleyuan, Beijing 100124, Peoples R China
  • [ 2 ] [Feng, Yili]Beijing Univ Technol, Fac Environm & Life, Dept Biomed Engn, 100 Pingleyuan, Beijing 100124, Peoples R China
  • [ 3 ] [Liu, Youjun]Beijing Univ Technol, Fac Environm & Life, Dept Biomed Engn, 100 Pingleyuan, Beijing 100124, Peoples R China
  • [ 4 ] [Yang, Haisheng]Beijing Univ Technol, Fac Environm & Life, Dept Biomed Engn, 100 Pingleyuan, Beijing 100124, Peoples R China
  • [ 5 ] [Willie, Bettina M.]McGill Univ, Shriners Hosp Children Canada, Res Ctr, Dept Pediat Surg, Montreal, PQ, Canada

Reprint Author's Address:

  • [Yang, Haisheng]Beijing Univ Technol, Fac Environm & Life, Dept Biomed Engn, 100 Pingleyuan, Beijing 100124, Peoples R China

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Source :

JOURNAL OF ORTHOPAEDIC RESEARCH

ISSN: 0736-0266

Year: 2021

Issue: 3

Volume: 40

Page: 634-643

2 . 8 0 0

JCR@2022

ESI Discipline: CLINICAL MEDICINE;

ESI HC Threshold:75

JCR Journal Grade:2

Cited Count:

WoS CC Cited Count: 2

SCOPUS Cited Count: 21

ESI Highly Cited Papers on the List: 0 Unfold All

WanFang Cited Count:

Chinese Cited Count:

30 Days PV: 1

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