The design of a fracture movement transducer

 The literature on bone growth, fracture healing, fracture treatment and the effects of forces and movements on these is reviewed. Some methods of assessing the progress of fracture union are considered. The conclusion from this is that a fracture movement transducer is needed for use on an external fracture fixator, and the design criteria are outlined. The possible types of transducers are considered and a system of light falling on lateral effect photodetectors was used. The linearizing algorithms applicable to the employed detectors are discussed and tested. The electronic circuits were designed and revised, initially to produce a reasonable power consumption, and then to give a system with reduced noise levels and improved linearity. Isolation amplifiers were required to prevent leakage currents reaching the patient from the mains powered computer. The algorithms relating the movements of the transducer to the movements at the fracture site were derived, including the use of elasticity theory to calculate the bending of the fixator pins. The engineering descriptions of the patient tests and the methods of calculating the fracture stiffness are considered. The transducer was calibrated, and consideration was given to the effect of the fixator pins loosening in the bone. Seven patients, all with tibial fractures, six injured in road traffic accidents and one footballing injury, were tested and their clinical histories were reviewed. Comparison was made between the results from the displacement transducer and a strain gauge transducer, related to the clinical history. It is concluded that this transducer, although useful, has more relevance as a research than as a clinical tool, but that further tests would lead to increased further understanding of fracture healing.

[1]  T. Koch,et al.  Bending stiffness of unilateral and bilateral external fixator frames , 1983 .

[2]  A. Goodship,et al.  Functional adaptation of bone to increased stress. An experimental study. , 1979, The Journal of bone and joint surgery. American volume.

[3]  J. Kenwright,et al.  Control of movement and fracture stiffness monitoring with external fixation. , 1984, Orthopedics.

[4]  R. J. O'Reilly,et al.  Can serial scintigraphic studies detect delayed fracture union in man? , 1981, Clinical orthopaedics and related research.

[5]  E. M. Bick Source book of orthopaedics , 1937 .

[6]  G. Eggers,et al.  The influence of the contact-compression factor on osteogenesis in surgical fractures. , 1949, The Journal of bone and joint surgery. American volume.

[7]  John C. Koch,et al.  The laws of bone architecture , 1917 .

[8]  W. Bonfield,et al.  Crack velocity dependence of longitudinal fracture in bone , 1980 .

[9]  R. Allum,et al.  A retrospective review of the healing of fractures of the shaft of the tibia with special reference to the mechanism of injury. , 1980, Injury.

[10]  J L Lewis A dynamic model of a healing fractured long bone. , 1975, Journal of biomechanics.

[11]  D. Levy A PULSED ELECTRICAL STIMULATION TECHNIQUE FOR INDUCING BONE GROWTH , 1974, Annals of the New York Academy of Sciences.

[12]  S. Olerud,et al.  Fractures of the tibial shaft; a critical evaluation of treatment alternatives. , 1974, Clinical orthopaedics and related research.

[13]  H. Haynes TREATING FRACTURES BY SKELETAL, FIXATION OF THE INDIVIDUAL BONE , 1939 .

[14]  K E Tanner,et al.  The Oxford External Fixator: fixator stiffness and the effects of bone pin loosening. , 1985, Engineering in medicine.

[15]  G. Laros Fracture healing. Compression vs fixation. , 1974, Archives of surgery.

[16]  Z. Jaworski,et al.  Effect of long-term immobilisation on the pattern of bone loss in older dogs. , 1980, The Journal of bone and joint surgery. British volume.

[17]  I. Siegel,et al.  The determination of fracture healing by measurement of sound velocity across the fracture site. , 1958, Surgery, gynecology & obstetrics.

[18]  F G Lippert,et al.  The feasibility of photogrammetry as a clinical research tool. , 1973, Journal of biomechanics.

[19]  P. Paavolainen,et al.  Studies on mechanical strength of bone. II. Torsional strength of cortial bone after rigid plate fixation with and without compression. , 1978, Acta orthopaedica Scandinavica.

[20]  D. Davy,et al.  Fracture healing in weight-bearing and nonweight-bearing bones. , 1978, Journal of Trauma.

[21]  R. Sallen,et al.  A practical method of designing RC active filters , 1955, IRE Transactions on Circuit Theory.

[22]  T. J. Hirsch,et al.  Modulus of Elasticity iof Concrete Affected by Elastic Moduli of Cement Paste Matrix and Aggregate , 1962 .

[23]  Wynn-Jones Ch A simple external fixation method using wire and bone cement , 1978 .

[24]  R. Johnston Advances in external fixation , 1980 .

[25]  J. Wallmark A New Semiconductor Photocell Using Lateral Photoeffect , 1957, Proceedings of the IRE.

[26]  K. Aalto,et al.  The deformation of external fixation devices during loading , 2004, International Orthopaedics.

[27]  J. Currey,et al.  The Mechanical Properties of Bone , 1970, Clinical orthopaedics and related research.

[28]  S Saha,et al.  The effect of soft tissue on wave-propagation and vibration tests for determining the in vivo properties of bone. , 1977, Journal of biomechanics.

[29]  E. Nicoll FRACTURES OF THE TIBIAL SHAFT. A SURVEY OF 705 CASES. , 1964, The Journal of bone and joint surgery. British volume.

[30]  G. Hierholzer,et al.  External Fixation , 2020, Pelvic Ring Fractures.

[31]  S L Woo,et al.  An interdisciplinary approach to evaluate the effect of internal fixation plate on long bone remodeling. , 1977, Journal of biomechanics.

[32]  A Sarmiento,et al.  Fracture healing in rat femora as affected by functional weight-bearing. , 1977, The Journal of bone and joint surgery. American volume.

[33]  L Gui,et al.  A new device ("G3 - IOR") for external fixation. , 1980, Italian journal of orthopaedics and traumatology.

[34]  John Kenwright,et al.  External Fracture Fixation—the Analysis and Design of a New System , 1979 .

[35]  W. Bonfield,et al.  Fracture mechanics of bone--the effects of density, specimen thickness and crack velocity on longitudinal fracture. , 1984, Journal of biomechanics.

[36]  W. P. Connors Lateral photodetector operating in the fully reverse-biased mode , 1971 .

[37]  Z. Friedenberg,et al.  The effects of known compression forces on fracture healing. , 1952, Surgery, gynecology & obstetrics.

[38]  A Jernberger,et al.  Measurement of stability of tibial fractures. A mechanical method. , 1970, Acta orthopaedica Scandinavica. Supplementum.

[39]  J. Watson The electrical stimulation of bone healing , 1979, Proceedings of the IEEE.

[40]  Subrata Saha,et al.  Longitudinal shear properties of human compact bone and its constituents, and the associated failure mechanisms , 1977 .

[41]  W. Abendschein,et al.  Ultrasonics and selected physical properties of bone. , 1970, Clinical orthopaedics and related research.

[42]  F. W. Rhinelander The normal microcirculation of diaphyseal cortex and its response to fracture. , 1968, The Journal of bone and joint surgery. American volume.

[43]  E Y Chao,et al.  Rigidity and stress analyses of external fracture fixation devices--a theoretical approach. , 1982, Journal of biomechanics.

[44]  G. Lucovsky Photoeffects in Nonuniformly Irradiated p‐n Junctions , 1960 .

[45]  G Karlström,et al.  Percutaneous pin fixation of open tibial fractures. Double-frame anchorage using the Vidal-Adrey method. , 1975, The Journal of bone and joint surgery. American volume.

[46]  A. White,et al.  Effects of compression and cyclical loading on fracture healing--a quantitative biomechanical study. , 1977, Journal of biomechanics.

[47]  A. M. Connell,et al.  TEXTBOOK OF PHYSIOLOGY AND BIOCHEMISTRY , 1951, The Ulster Medical Journal.

[48]  C L Davidson,et al.  Protection from stress in bone and its effects. Experiments with stainless steel and plastic plates in dogs. , 1976, The Journal of bone and joint surgery. British volume.

[49]  Paul Horowitz,et al.  The Art of Electronics , 1980 .

[50]  M M Panjabi,et al.  Mechanical properties of bone as a function of rate of deformation. , 1973, The Journal of bone and joint surgery. American volume.

[51]  John Goodfellow,et al.  Scientific foundations of orthopaedics and traumatology , 1980 .

[52]  H. Woltring,et al.  Single- and dual-axis lateral photodetectors of rectangular shape , 1975, IEEE Transactions on Electron Devices.

[53]  C Hirsch,et al.  The three dimensional measurement of tibia fracture motion by photogrammetry. , 1974, Clinical orthopaedics and related research.

[54]  M. Pope,et al.  Tibial shaft fractures in skiing , 1977, The American journal of sports medicine.

[55]  K. Piekarski Analysis of bone as a composite material , 1973 .

[56]  W. M. Webster,et al.  The Effective Surface Recombination of a Germaniun Surface with a Floating Barrier , 1955, Proceedings of the IRE.

[57]  M M Panjabi,et al.  The four biomechanical stages of fracture repair. , 1977, The Journal of bone and joint surgery. American volume.

[58]  W C Hayes,et al.  Monitoring fracture site properties with external fixation. , 1983, Journal of biomechanical engineering.

[59]  A. U. Daniels,et al.  Effects of flexural rigidity of plates on bone healing. , 1979, The Journal of bone and joint surgery. American volume.

[60]  E F Rybicki,et al.  Quantification of bone stresses during remodeling. , 1980, Journal of biomechanics.

[61]  K. Tanner,et al.  Fracture healing assessment with external fixation. , 1985, Engineering in medicine.

[62]  P Edholm,et al.  Stability of union after tibial shaft fracture. Analysis by a non-invasive technique. , 1984, The Journal of bone and joint surgery. British volume.

[63]  Measurements of healing at an osteotomy in a rabbit calvarium: the influence of applied compressive stress on collagen synthesis and calcification. , 1974, Journal of biomechanics.

[64]  J. States,et al.  Factors influencing the rate of healing in tibial shaft fractures. , 1967, Surgery, gynecology & obstetrics.

[65]  A Chamay,et al.  Mechanical influences in bone remodeling. Experimental research on Wolff's law. , 1972, Journal of biomechanics.

[66]  The effects of mechanical vibration on bone development in the rat. , 1972, Journal of biomechanics.