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骨折愈合的重新定义。

Fracture healing redefined.

作者信息

Braun B J, Rollmann M, Veith N, Pohlemann T

机构信息

Department of Trauma-, Hand-, Reconstructive Surgery, Saarland University Hospital, Homburg, Germany.

Department of Trauma-, Hand-, Reconstructive Surgery, Saarland University Hospital, Homburg, Germany.

出版信息

Med Hypotheses. 2015 Dec;85(6):940-3. doi: 10.1016/j.mehy.2015.09.006. Epub 2015 Sep 5.

Abstract

It is well established that local mechanical conditions and interfragmentary movement are important factors for successful bone healing and may vary dramatically with patient fracture-load and activity. Up until now however it was technically impossible to use these key influence parameters in the aftercare treatment process of human lower extremity fractures. We propose a theory that with state of the art sensor technology these biomechanical influences can not only be monitored in vivo, but also used for individualized therapy protocols. Local measurement systems for fracture healing are available but remain research tools, due to various technical issues. To investigate the biomechanical influences on healing right away surrogate sensor tools are needed. Various gait characteristics have been proposed as surrogate measures. Currently available sensor tools could be modified with the appropriate support structure to allow such measurements continuously over the course of a fracture healing. Interdisciplinary work between clinicians, software engineers with computer and biomechanical simulations is needed. Through such a sensor system human boundary conditions for fracture healing could not only be defined for the first time, but also used for a unique, extendible aftercare system. With this tool critical healing situations would be detected much earlier and could be prevented with easy activity modifications, reducing patient and socioeconomic burden of disease. The hypothesis, necessary tools and support structures are presented.

摘要

众所周知,局部力学条件和骨折块间的移动是骨愈合成功的重要因素,且可能因患者的骨折负荷和活动情况而有显著差异。然而,到目前为止,在人类下肢骨折的后续治疗过程中,从技术角度而言,尚无法使用这些关键影响参数。我们提出一种理论,即借助先进的传感器技术,不仅可以在体内监测这些生物力学影响,还可将其用于个性化治疗方案。用于骨折愈合的局部测量系统虽已存在,但由于各种技术问题,仍仅为研究工具。为了立即研究对愈合的生物力学影响,需要替代传感工具。各种步态特征已被提议作为替代指标。当前可用的传感器工具可通过适当的支撑结构进行改进,以便在骨折愈合过程中持续进行此类测量。临床医生、具备计算机和生物力学模拟能力的软件工程师之间需要开展跨学科合作。通过这样一个传感器系统,不仅能够首次定义骨折愈合的人体边界条件,还可将其用于独特的、可扩展的后续护理系统。借助该工具,关键的愈合情况能够被更早地检测到,并且通过简单的活动调整即可预防,从而减轻患者负担和社会经济疾病负担。本文介绍了相关假设、必要工具和支撑结构。

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