Biomechanical role of bone grafting for calcaneal fracture fixation in the presence of bone defect: A finite element analysis

IF 1.4 3区 医学 Q4 ENGINEERING, BIOMEDICAL Clinical Biomechanics Pub Date : 2024-06-01 DOI:10.1016/j.clinbiomech.2024.106278
Zhihao Su , Ming Ding , Ning Zhu , James Chung-Wai Cheung , Duo Wai-Chi Wong , Wanju Sun , Ming Ni
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Abstract

Background

The purpose of this study was to compare the biomechanical stress and stability of calcaneal fixations with and without bone defect, before and after bone grafting, through a computational approach.

Methods

A finite element model of foot-ankle complex was reconstructed, impoverished with a Sanders III calcaneal fracture without bone defect and with moderate and severe bone defects. Plate fixations with and without bone grafting were introduced with walking stance simulated. The stress and fragment displacement of the calcaneus were evaluated.

Findings

Moderate and severe defect increased the calcaneus stress by 16.11% and 32.51%, respectively and subsequently decreased by 10.76% and 20.78% after bone grafting. The total displacement was increased by 3.99% and 24.26%, respectively by moderate and severe defect, while that of posterior joint facet displacement was 86.66% and 104.44%. The former was decreased by 25.73% and 35.96% after grafting, while that of the latter was reduced by 88.09% and 84.78% for moderate and severe defect, respectively.

Interpretation

Our finite element prediction supported that bone grafting for fixation could enhance the stability and reduce the risk of secondary stress fracture in cases of bone defect in calcaneal fracture.

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骨缺损情况下骨移植在小腿骨骨折固定中的生物力学作用:有限元分析
背景 本研究的目的是通过计算方法,比较有骨缺损和无骨缺损、植骨前后小腿骨固定的生物力学应力和稳定性。方法 重建了一个足踝复合体的有限元模型,该模型为无骨缺损的桑德斯 III 型小腿骨骨折,以及中度和重度骨缺损。在模拟行走姿态的情况下,采用了带植骨和不带植骨的钢板固定。结果 中度和重度骨缺损使小腿骨应力分别增加了 16.11% 和 32.51%,植骨后分别减少了 10.76% 和 20.78%。中度和重度缺损使总移位分别增加了3.99%和24.26%,而后关节面移位则分别增加了86.66%和104.44%。我们的有限元预测结果表明,植骨固定可增强稳定性,降低小关节骨折骨质缺损患者继发应力性骨折的风险。
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来源期刊
Clinical Biomechanics
Clinical Biomechanics 医学-工程:生物医学
CiteScore
3.30
自引率
5.60%
发文量
189
审稿时长
12.3 weeks
期刊介绍: Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.
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