Smart fracture plate for quantifying fracture healing: Preliminary efficacy in a biomechanical model.

Autor: Ledet EH; Department of Biomedical Engineering, Rensselaer Polytechnic Institute & Research and Development Service, Stratton VA Medical Center, Albany, New York, USA., Caparaso SM; Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, New York, USA., Stout M; Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, New York, USA., Cole KP; Division of Orthopaedic Surgery, Albany Medical College, Albany, New York, USA., Liddle B; Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, New York, USA., Cady NC; Department of Nanobio Science, State University of New York Polytechnic Institute, Utica, New York, USA., Archdeacon MT; Department of Orthopaedic Surgery, University of Cincinnati Medical Center, Cincinnati, Ohio, USA.
Jazyk: angličtina
Zdroj: Journal of orthopaedic research : official publication of the Orthopaedic Research Society [J Orthop Res] 2022 Oct; Vol. 40 (10), pp. 2414-2420. Date of Electronic Publication: 2022 Jan 06.
DOI: 10.1002/jor.25254
Abstrakt: The diagnosis of fracture nonunion following plate osteosynthesis is subjective and frequently ambiguous. Initially following osteosynthesis, loads applied to the bone are primarily transmitted through the plate. However, as callus stiffness increases, the callus is able to bear load proportional to its stiffness while forces through the plate decrease. The purpose of this study was to use a "smart" fracture plate to distinguish between phases of fracture healing by measuring forces transmitted through the plate. A wireless force sensor and small adapter were placed on the outside of a distal femoral locking plate. The adapter converts the slight bending of the plate under axial load into a transverse force which is measurable by the sensor. An osteotomy was created and then plated in the distal femur of biomechanical Sawbones. Specimens were loaded to simulate single-leg stance first with the osteotomy defect empty (acute healing), then sequentially filled with silicone (early callus) and then polymethyl methacrylate (hard callus). There was a strong correlation between applied axial load and force measured by the "smart" plate. Data demonstrate statistically significant differences between each phase of healing with as little as 150 N of axial load applied to the femur. Forces measured in the plate were significantly different between acute (100%), early callus (66.4%), and hard callus (29.5%). This study demonstrates the potential of a "smart" fracture plate to distinguish between phases of healing. These objective data may enable early diagnosis of nonunion and enhance outcomes for patients.
(© 2022 Orthopaedic Research Society. Published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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