Towards a Non-Invasive Technique for Healing Assessment of Internally Fixated Femur

Abstract

The lack of a quantitative method to adequately assess fractured bone healing that has undergone fixation limits prognostic capabilities on patients’ optimal return to work. This paper addresses the use of vibrational analysis to monitor the state of healing of a plate-screw fixated femur and supplement the current clinical radiographic assessment. This experimental study involves an osteotomised composite femur specimen enclosed by modelling clay to simulate the damping effect of overlying soft tissues. Epoxy adhesives are applied to the fractured region and to simulate the healing process. With the instrumentation described, the cross-spectrum and coherence are obtained and analysed in the frequency domain over a period of time. The results suggest that it is crucial to analyse the cross-spectrum and proposed healing index to quantitatively assess the stages of healing. The results also show that the mass loading effect due to modelling clay did not influence the proposed healing assessment technique. The findings indicate a potential non-intrusive technique to evaluate the healing of fractured femur by utilising the vibrational responses.

Real-Time Wireless Platform for In Vivo Monitoring of Bone Regeneration

“…Unlike other recent internal fixation systems [ 31 , 32 ], our devices were tested in vivo on sheep metatarsus, whose preliminary results in bone lengthening ( Figure 12 B) agree with other studies in the literature. The peak stiffness of the bone callus estimated during the distraction phase rises as more elongation is applied, as observed in other results in the literature [ 26 , 44 , 48 ].…”

“…On the one hand, Tan et al [ 31 ] developed a sensor for bone plate strain monitoring. On the other hand, Chiu et al [ 32 ] proposed a technique to assess the stiffness of an internally fixated femur based on its frequency response. However, the implementation of these sensors in internal fixations are restricted to bone or fracture healing processes.…”

Non-radiative healing assessment techniques for fractured long bones and osseointegrated implant

“…However, compared to the intramedullary nail, early load bearing is forbidden for patients with a compression plate. In addition, due to the high stiffness of the plate, a compression plate may delay callus formation and induce bone resorption [22].…”

Quantitative Monitoring of Osseointegrated Implant Stability Using Vibration Analysis

“…Recently, there is a significant research interest in using non-invasive approaches to monitor implant stability. Vibration analysis is a non-destructive structural health monitoring technique, which was firstly used in evaluating bone fracture healing [17][18][19] and monitoring the total hip arthroplasty loosening [20][21][22][23]. The methodology of using the dynamic response of the bone-implant system to assess the stiffness at the bone-implant interface is widely recognized [1,21,24].…”