Mechanical Considerations in Fracture Fixation. Effect of Fixation Stability on Healing and Bone Remodeling

      Аннотация: Bone’s capacity to repair following trauma is both unique and astounding. However, fractures sometimes fail to heal. Hence, the goal of fracture treatment is the restoration of bone’s structure, composition and function. Fracture fixation devices should provide a favourable mechanical and biological environment for healing to occur. The use of internal fixation is increasing as these devices may be applied with less invasive techniques. Recent studies suggest however that, internal fixation devices may be overly stiff and suppresses callus formation. The degree of mechanical stability influences the healing outcome. This is determined by the stiffness of the fixation device and the degree of limb loading.Furthermore,the stiffness of a fixation device also influences the physiological loads experienced by the healing bone. Since bone adapts to this applied load by undergoing changes through a remodelling process, undesirable changes could occur during the period of treatment with an implant. The knowledge gained through this book is expected to aid our understanding on how the configuration of internal fixation devices can promote timely healing and prevent undesirable bone loss.

Ключевые слова: BONE DENSITY, Bone Healing, bone remodelling, Internal fixation, Bone geometry, Contra-lateral bone, Fixation stability, Fixator configuration