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骨愈合和长期重塑的耦合计算框架：研究内固定对骨折的作用。

A coupled computational framework for bone fracture healing and long-term remodelling: Investigating the role of internal fixation on bone fractures.

机构信息

Biomedical Engineering and Biomechanics Research Centre, School of Engineering, National University of Ireland Galway, Ireland.

Meotec GmbH, Aachen, Germany.

出版信息

Int J Numer Method Biomed Eng. 2022 Jul;38(7):e3609. doi: 10.1002/cnm.3609. Epub 2022 May 11.

DOI:10.1002/cnm.3609
PMID:35485134
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9540005/
Abstract

In this study, a coupled computational modelling framework for bone fracture repair is presented that enables predictions of both healing and remodelling phases of the fracture region and is used to investigate the role of an internal fixation plate on the long-term healing performance of a fracture tibia under a range of different conditions. It was found that introduction of a titanium plate allowed the tibia to undergo successful healing at higher loading conditions and fracture gaps, compared with the non-plated versions. While these plated cases showed faster rates of repair in the healing phase, their performance was substantially different once they entered the remodelling phase, with substantial regions of stress shielding predicted. This framework is one of the few implementations of both fracture healing and remodelling phases of bone repair and includes several innovative approaches to smoothing, time-averaging and time incrementation in its implementation, thereby avoiding any unwanted abrupt changes between tissue phenotypes. This provides a better representation of tissue development in the fracture site when compared with fracture healing models alone and provides a suitable platform to investigate the long-term performance of orthopaedic fixation devices. This would enable the more effective design of permanent fixation devices and optimisation of the spatial and temporal performance of bioabsorbable implants.

摘要

本研究提出了一种用于骨折修复的计算建模框架，该框架可以预测骨折区域的愈合和重塑阶段，并用于研究在不同条件下内固定板对骨折胫骨长期愈合性能的影响。研究发现，与未使用钢板的情况相比，钛板的引入使得胫骨在更高的载荷条件和骨折间隙下能够成功愈合。虽然这些使用钢板的情况在愈合阶段显示出更快的修复速度，但一旦进入重塑阶段，它们的性能就会有很大的不同，预计会出现大量的应力屏蔽区域。该框架是少数同时实现骨折愈合和骨修复重塑阶段的框架之一，在实现过程中采用了平滑、时间平均和时间增量的创新方法，从而避免了组织表型之间的任何不必要的突然变化。与单独的骨折愈合模型相比，这为骨折部位的组织发育提供了更好的表示，并为研究骨科固定装置的长期性能提供了合适的平台。这将能够更有效地设计永久性固定装置，并优化生物可吸收植入物的空间和时间性能。

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