Abstract
Simulating diaphyseal fracture healing via numerical models has been investigated for a long time. It is apparent from in vivo studies that metaphyseal fracture healing should follow similar biomechanical rules although the speed and healing pattern might differ. To investigate this hypothesis, a pre-existing, well-established diaphyseal fracture healing model was extended to study metaphyseal bone healing. Clinical data of distal radius fractures were compared to corresponding geometrically patient-specific fracture healing simulations. The numerical model, was able to predict a realistic fracture healing process in a wide variety of radius geometries. Endochondral and mainly intramembranous ossification was predicted in the fractured area without callus formation. The model, therefore, appears appropriate to study metaphyseal bone healing under differing mechanical conditions and metaphyseal fractures in different bones and fracture types. Nevertheless, the outlined model was conducted in a simplified rotational symmetric case. Further studies may extend the model to a three-dimensional representation to investigate complex fracture shapes. This will help to optimize clinical treatments of radial fractures, medical implant design and foster biomechanical research in metaphyseal fracture healing.
Highlights
Accounting for 17% of all emergency department visits [1], distal radius fractures (DRFs) are the most common long-bone fracture
The predicted fracture healing results of four patient-specific distal radius fractures are compared in Figure 4 by an emulated pseudo-X-ray view to longitudinal in vivo X-ray scans of the corresponding patient
The fractured area was totally healed after one year
Summary
Accounting for 17% of all emergency department visits [1], distal radius fractures (DRFs) are the most common long-bone fracture. Its incidence is increasing because of an active lifestyle and an ageing society [1,2,3,4]. A DRF is a high-impact trauma that occurs in young patients during a fall, while in older patients it is characterized by a low-energy fracture occurring above the distal articular surface of the radius. DRFs can be categorized according to different classification schemes, depending on the type of defect and trauma [2,5,6]. DRFs can be treated either conservatively or by surgical intervention where the main objectives are repositioning, fracture reduction and immobilization to maintain the reduction [7,8]
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