Naveiro José M, Gracia Luis, Roces Jorge, Albareda Jorge, Puértolas Sergio
Department of Mechanical Engineering, University of Zaragoza, 50018 Zaragoza, Spain.
Aragón Institute for Engineering Research, 50018 Zaragoza, Spain.
Bioengineering (Basel). 2023 Feb 2;10(2):190. doi: 10.3390/bioengineering10020190.
Bone fractures are among the most common and potentially serious injuries to the skeleton, femoral shaft fractures being especially severe. Thanks to recent advances in the area of in silico analysis, several approximations of the bone healing process have been achieved. In this context, the objective of this work was to simulate the initial phase of callus formation in long bones, without a pre-meshed domain in the 3D space. A finite element approach was computationally implemented to obtain the values of the cell concentrations along the whole domain and evaluate the areas where the biological quantities reached the thresholds necessary to trigger callus growth. A voxel model was used to obtain the 3D domain of the bone fragments and callus. A mesh growth algorithm controlled the addition of new elements to the domain at each step of the iterative procedure until complete callus formation. The implemented approach is able to reproduce the generation of the primary callus, which corresponds to the initial phase of fracture healing, independently of the fracture type and complexity, even in the case of several bone fragments. The proposed approach can be applied to the most complex bone fractures such as oblique, severely comminuted or spiral-type fractures, whose simulation remains hardly possible by means of the different existing approaches available to date.
骨折是骨骼最常见且可能最严重的损伤之一，股骨干骨折尤为严重。得益于计算机模拟分析领域的最新进展，现已实现了对骨愈合过程的几种近似模拟。在此背景下，本研究的目的是在三维空间中不使用预网格化区域的情况下，模拟长骨骨痂形成的初始阶段。通过计算实现了一种有限元方法，以获取整个区域内细胞浓度的值，并评估生物量达到触发骨痂生长所需阈值的区域。使用体素模型来获取骨碎片和骨痂的三维区域。一种网格生长算法在迭代过程的每个步骤中控制向区域添加新元素，直至完全形成骨痂。所实施的方法能够再现初级骨痂的生成，这对应于骨折愈合的初始阶段，且与骨折类型和复杂性无关，即使在存在多个骨碎片的情况下也是如此。所提出的方法可应用于最复杂的骨折，如斜形、严重粉碎性或螺旋形骨折，而利用目前现有的不同方法几乎无法对其进行模拟。
