Partial weight bearing of the tibia

Ganse, Bergita; Yang, Pengfei; Gardlo, Jenny; Gauger, Peter; Kriechbaumer, Andreas; Pape, Hans-Christian; Koy, Timmo; Müller, L. P.; Rittweger, Jörn

doi:10.1016/j.injury.2016.06.003

Cited by 8 publications

(7 citation statements)

References 13 publications

(36 reference statements)

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“…The specimens were loaded five times under static axial loads of 50, 100, 150 and 200 N equivalent to partial weight bearing. 24,25 Note, normal limb loads are approximately of 3xBW, but the use of far lower loads here is due to the fact that the subjects do not weight bear significantly during distraction osteogenesis, and are in line with measurements of frame loads carried out in author's lab. 26 At the end of each loading scenario, (1) the overall stiffness of the constructs were calculated based on the load-displacement data from the material testing machine; (2) the displacement at the fracture gap under the static loads was recorded with a calliper (with the resolution of 0.01 mm) on the lateral side and (3) the vibrating platform was turned on to vibrate the tibial shaft along its long axis.…”

Section: Loading and Measurementssupporting

confidence: 57%

supporting

confidence: 57%

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An experimental evaluation of fracture movement in two alternative tibial fracture fixation models using a vibrating platform

Moazen

Calder

Koroma

et al. 2019

Proc Inst Mech Eng H

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Several studies have investigated the effect of low-magnitude-high-frequency vibration on the outcome of fracture healing in animal models. The aim of this study was to quantify and compare the micromovement at the fracture gap in a tibial fracture fixed with an external fixator in both a surrogate model of a tibial fracture and a cadaver human leg under static loading, both subjected to vibration. The constructs were loaded under static axial loads of 50, 100, 150 and 200 N and then subjected to vibration at each load using a commercial vibration platform, using a DVRT sensor to quantify static and dynamic fracture movement. The overall stiffness of the cadaver leg was significantly higher than the surrogate model under static loading. This resulted in a significantly higher facture movement in the surrogate model. Under vibration the fracture movements induced at the fracture gap in the surrogate model and the cadaver leg were 0.024±0.009 mm and 0.016±0.002 mm respectively, at 200N loading. Soft tissues can alter the overall stiffness and fracture movement recorded in biomechanical studies investigating the effect of various devices or therapies. While the relative comparison between the devices or therapies may remain valid, absolute magnitude of recordings measured externally must be interpreted with caution.

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Section: Loading and Measurementssupporting

confidence: 57%

supporting

confidence: 57%

An experimental evaluation of fracture movement in two alternative tibial fracture fixation models using a vibrating platform

Moazen

Calder

Koroma

et al. 2019

Proc Inst Mech Eng H

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“…In the present study, we likely identified the two parameters walking speed and weight-bearing restriction to have an impact on the bone healing process in silico . While weight-bearing is already widely accepted to be influential for bone healing but is known to have a low compliance rate ( Frost, 2004 ; Ganse et al, 2016 ; Braun et al, 2017 ), we showed by the simulation derived from individual motion data, that the different phases and the walking speed of the gait cycle have an impact on the force elements within the fracture gap. During the phases of maximum force in axial direction (terminal stance phase) and maximum of occurring moments (pre-swing phase), and increase of walking speed to 2.0 km/h revealed more elements to be outside the range of beneficial mechanical properties for bone healing and bone formation ( Claes and Heigele, 1999 ; Shefelbine et al, 2005 ).…”

Section: Discussionmentioning

confidence: 73%

Simulation-based prediction of bone healing and treatment recommendations for lower leg fractures: Effects of motion, weight-bearing and fibular mechanics

Orth

Ganse²,

Andres³

et al. 2023

Front. Bioeng. Biotechnol.

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Despite recent experimental and clinical progress in the treatment of tibial and fibular fractures, in clinical practice rates of delayed bone healing and non-union remain high. The aim of this study was to simulate and compare different mechanical conditions after lower leg fractures to assess the effects of postoperative motion, weight-bearing restrictions and fibular mechanics on the strain distribution and the clinical course. Based on the computed tomography (CT) data set of a real clinical case with a distal diaphyseal tibial fracture, a proximal and a distal fibular fracture, finite element simulations were run. Early postoperative motion data, recorded via an inertial measuring unit system and pressure insoles were recorded and processed to study strain. The simulations were used to compute interfragmentary strain and the von Mises stress distribution of the intramedullary nail for different treatments of the fibula, as well as several walking velocities (1.0 km/h; 1.5 km/h; 2.0 km/h) and levels of weight-bearing restriction. The simulation of the real treatment was compared to the clinical course. The results show that a high postoperative walking speed was associated with higher loads in the fracture zone. In addition, a larger number of areas in the fracture gap with forces that exceeded beneficial mechanical properties longer was observed. Moreover, the simulations showed that surgical treatment of the distal fibular fracture had an impact on the healing course, whereas the proximal fibular fracture barely mattered. Weight-bearing restrictions were beneficial in reducing excessive mechanical conditions, while it is known that it is difficult for patients to adhere to partial weight-bearing recommendations. In conclusion, it is likely that motion, weight bearing and fibular mechanics influence the biomechanical milieu in the fracture gap. Simulations may improve decisions on the choice and location of surgical implants, as well as give recommendations for loading in the postoperative course of the individual patient.

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“…Single support phases usually comprise more than 60% of the cycle [ 27 ]. Clinicians rely on this particular phase to evaluate the partial weight-bearing during the rehabilitation process [ 24 , 25 ]. Rollators offer the most support in these phases, by decreasing loads on the support leg to reduce pain and improve balance.…”

Section: Gait Assessment Using a Smart Rollatormentioning

confidence: 99%

“…This work illustrates how partial weight bearing can be estimated while the user walks. This parameter is of interest because (i) it is important from a clinical point of view [ 24 , 25 ], and (ii) measuring support in clinical tests typically requires a fixed environments or direct expert intervention, and that may alter results [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

Walk-IT: An Open-Source Modular Low-Cost Smart Rollator

Fernández-Carmona

Ballesteros

Boladeras

et al. 2022

Sensors

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Rollators are widely used in clinical rehabilitation for gait assessment, but gait analysis usually requires a great deal of expertise and focus from medical staff. Smart rollators can capture gait parameters autonomously while avoiding complex setups. However, commercial smart rollators, as closed systems, can not be modified; plus, they are often expensive and not widely available. This work presents a low cost open-source modular rollator for monitorization of gait parameters and support. The whole system is based on commercial components and its software architecture runs over ROS2 to allow further customization and expansion. This paper describes the overall software and hardware architecture and, as an example of extended capabilities, modules for monitoring dynamic partial weight bearing and for estimation of spatiotemporal gait parameters of clinical interest. All presented tests are coherent from a clinical point of view and consistent with input data.

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Partial weight bearing of the tibia

Cited by 8 publications

References 13 publications

An experimental evaluation of fracture movement in two alternative tibial fracture fixation models using a vibrating platform

An experimental evaluation of fracture movement in two alternative tibial fracture fixation models using a vibrating platform

Simulation-based prediction of bone healing and treatment recommendations for lower leg fractures: Effects of motion, weight-bearing and fibular mechanics

Walk-IT: An Open-Source Modular Low-Cost Smart Rollator

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