Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia.
J Biomech. 2009 Nov 13;42(15):2575-83. doi: 10.1016/j.jbiomech.2009.07.010. Epub 2009 Aug 5.
The healing process for bone fractures is sensitive to mechanical stability and blood supply at the fracture site. Most currently available mechanobiological algorithms of bone healing are based solely on mechanical stimuli, while the explicit analysis of revascularization and its influences on the healing process have not been thoroughly investigated in the literature. In this paper, revascularization was described by two separate processes: angiogenesis and nutrition supply. The mathematical models for angiogenesis and nutrition supply have been proposed and integrated into an existing fuzzy algorithm of fracture healing. The computational algorithm of fracture healing, consisting of stress analysis, analyses of angiogenesis and nutrient supply, and tissue differentiation, has been tested on and compared with animal experimental results published previously. The simulation results showed that, for a small and medium-sized fracture gap, the nutrient supply is sufficient for bone healing, for a large fracture gap, non-union may be induced either by deficient nutrient supply or inadequate mechanical conditions. The comparisons with experimental results demonstrated that the improved computational algorithm is able to simulate a broad spectrum of fracture healing cases and to predict and explain delayed unions and non-union induced by large gap sizes and different mechanical conditions. The new algorithm will allow the simulation of more realistic clinical fracture healing cases with various fracture gaps and geometries and may be helpful to optimise implants and methods for fracture fixation.
骨折的愈合过程对骨折部位的机械稳定性和血液供应很敏感。目前大多数可用的骨愈合机械生物学算法仅基于机械刺激，而关于血管再生及其对愈合过程的影响，文献中尚未进行彻底的分析。在本文中，血管再生通过两个独立的过程来描述：血管生成和营养供应。已经提出了血管生成和营养供应的数学模型，并将其集成到现有的骨折愈合模糊算法中。由应力分析、血管生成和营养供应分析以及组织分化组成的骨折愈合计算算法已在先前发表的动物实验结果上进行了测试和比较。模拟结果表明，对于小到中等大小的骨折间隙，营养供应足以促进骨愈合，对于大的骨折间隙，由于营养供应不足或机械条件不足，可能会导致不愈合。与实验结果的比较表明，改进的计算算法能够模拟广泛的骨折愈合病例，并预测和解释由于大间隙尺寸和不同机械条件引起的延迟愈合和不愈合。新算法将允许模拟具有各种骨折间隙和几何形状的更现实的临床骨折愈合病例，并可能有助于优化骨折固定的植入物和方法。
