Relation between mechanical stiffness and vibration transmission of fracture callus: an experimental study on rabbit tibia

Application of stacked autoencoder for identification of bone fracture

This study presents a stacked autoencoder (SAE)-based assessment method which is one of the unsupervised learning schemes for the investigation of bone fracture. Relatively accurate health monitoring of bone fracture requires considering physical interactions among tissue, muscle, wave propagation and boundary conditions inside the human body. Furthermore, the investigation of fracture, crack and healing process without state-of-the-art medical devices such as CT, X-ray and MRI systems is challenging. To address these issues, this study presents the SAE method that incorporates bilateral symmetry of the human legs and low-frequency transverse vibration. To verify the presented method, several examples are employed with plastic pipes, cadaver legs and human legs. Virtual spectrograms, created by applying a short-time Fourier transform to the differences in vibration responses, are employed for image-based training in SAE. The virtual spectrograms are then classified and the fine-tuning is also carried out to increase the accuracy. Moreover, a confusion matrix is employed to evaluate classification accuracy and training validity.

Evaluation of a topical herbal agent for the promotion of bone healing

A topically used Chinese herbal paste, namely, CDNR, was designed to facilitate fracture healing which is usually not addressed in general hospital care. From our in vitro studies, CDNR significantly inhibited the release of nitric oxide from RAW264.7 cells by 51 to 77%. This indicated its anti-inflammatory effect. CDNR also promoted the growth of bone cells by stimulating the proliferation of UMR106 cells up to 18%. It also increased the biomechanical strength of the healing bone in a drill-hole defect rat model by 16.5% significantly. This result revealed its in vivo efficacy on facilitation of bone healing. Furthermore, the detection of the chemical markers of CDNR in the skin and muscle of the treatment area demonstrated its transdermal properties. However, CDNR did not affect the bone turnover markers in serum of the rats. With its anti-inflammatory and bone formation properties, CDNR is found effective in promoting bone healing.

Vibration measurements predict the mechanical properties of human tibia

BACKGROUND

Vibration analysis is a promising technique in diagnosing metabolic bone diseases such as osteoporosis and monitoring fracture healing. The aim of this study is to observe the structural dynamic property changes of the tibia extracted from the vibration analysis data.

METHODS

In this study, bone mineral density and vibration measurements were made both in in vivo and in vitro conditions. The relationship between structural dynamic properties, obtained and bone mineral densities measured were investigated. Also, the effect of soft tissues on measured structural dynamic properties was analyzed.

FINDINGS

Natural frequency of the tibia decreased with decreasing bone mineral density that presented a weak correlation with the bone mineral density values measured by dual energy X-ray densitometer of the femur. In the case of in vitro experiments, it was observed that the effect of muscles on measurement results is higher than that of the effect of the skin and the fibula which makes the modal identification procedure difficult. However, having very large percentage changes in the loss factors when mineral content and collagen are reduced is an encouraging result to believe that damping measurements may yield a promising technique in diagnosing progressing osteoporosis and monitoring fracture healing period.

INTERPRETATION

The utilization of natural frequency alone as a diagnosing tool does not seem to be a sufficient method although there is a correlation between this parameter and bone mineral density. However, in vitro experiments showed that the identification of the loss factor is a promising technique in diagnosing progressing osteoporosis.

Can rhBMP-2 containing collagen sponges enhance bone repair in ovariectomized rats?: a preliminary study

With an aging population the frequency of postmenopausal fractures is increasing. Methods to enhance the repair of osteoporotic bone repair therefore become more important to reduce the society burden of care. We asked if absorbable collagen sponges containing recombinant human bone morphogenetic protein-2 (rhBMP-2) have the potential to enhance bone repair. We randomly assigned 40 rats into the ovariectomy and sham operation groups. A segmental defect was created in the right tibia 12 weeks after ovariectomy. rhBMP-2-containing absorbable collagen sponges were implanted into the defect in half of the animals in each group. We analyzed radiographs and histological sections and performed three-point bending tests to assess repair. Radiological scores in the rhBMP-2 applied rats were higher than those in controls at the end of 8 weeks after tibial osteotomy. The specimens failed under higher loads in the rhBMP-2-applied groups and histology revealed a higher fracture healing score, including callus formation, bone union, marrow changes, and cortex remodeling. We observed no adverse tissue responses such as fibrous connective tissue formation and inflammatory cellular infiltration. rhBMP-2 in absorbable collagen sponges enhanced bone repair in segmental tibial defects of ovariectomized rats. The sponges with rhBMP-2 appeared to enhance bone repair.

Early weight bearing of porous HA/TCP (60/40) ceramics in vivo: a longitudinal study in a segmental bone defect model of rabbit

Porous interconnected hydroxyapatite (HA) and HA/tricalcium phosphate (TCP) (60/40) ceramics are promising materials for hard tissue repair. However, the mechanical properties of these materials have not been accurately determined under weight-bearing conditions. In this study, newly developed HA and HA/TCP (60/40) ceramics were used with intramedullary fixation in segmental bone defects of rabbits. Early radiological, histological, densitometric and biomechanical changes were evaluated. The mean radiological grade of healing and bonding to bone was higher in HA/TCP (60/40) ceramics than that of pure HA ceramics but the difference was not statistically significant. The densities of both implanted ceramics improved with time, supported by the histological evaluation of bone matrix ingrowth into ceramic pores, whereas the densities at the bone-ceramic interface decreased gradually. Flexural resonant frequencies and three-point bending strength increased, revealing an increase in mechanical stability during this early critical time interval where implant and/or bone-implant interface failures occur frequently. It can be concluded that both HA and HA/TCP (60/40) ceramics have a limited application in the treatment of load-bearing segmental bone defects but did not fail at the early stages of implantation.

Vibrational analysis of mandible trauma: experimental and numerical approaches

The aim of this study was to evaluate the effectiveness of vibrational assessment of the mandible fracture patterns. Measurement of natural frequencies and associated vibrational mode shapes was performed to determine the relationship between the dynamic behavior of the human mandible and incidence of mandibular fractures using both in vitro modal testing and finite element analysis. Our results show that the natural frequencies of the human mandible in dry and wet conditions are 567 Hz and 501 Hz, respectively. The first vibrational mode of human mandible is a bending vibration with nodes located at the mandibular body where bone fracture is less likely to occur. By contrast, high vibration amplitudes were identified in the symphysis/parasymphysis and subcondyle regions where bone fractures tend occur. These findings indicate that the vibrational characteristics of the mandible are potential parameters for assessment of the mechanisms of injury.

Changes in joint stability with muscle contraction measured from transmission of mechanical vibration

A non-invasive in vivo technique was developed to evaluate changes in wrist joint stability properties induced by increased co-activation of the forearm muscles in a gripping task. Mechanical vibration at 45, 50 and 55 Hz was applied to the radial head in ten healthy volunteers. Vibrations of the styloid process of the radius and the distal end of the metacarpal bone of the index finger were measured with triaxial accelerometers. Joint stability properties were quantified by the transfer function gain between accelerations on either side of the wrist-joint. Gain was calculated with the muscles at rest and at five force levels ranging from 5% to 25% of maximum grip force (%MF). During contraction the gain was significantly greater than in control trial (0%MF) for all contractions levels at 45 and 50 Hz and a trend for 15%MF and higher at 55 Hz. Group means of contraction force and gain were significantly correlated at 45 (R(2)=0.98) and 50 Hz (R(2)=0.72), but not at 55 Hz (R(2)=0.10). In conclusion, vibration transmission gain may provide a method to evaluate changes in joint stability properties.

The effects of dynamization and destabilization of the external fixator on fracture healing: a comparative biomechanical study in dogs

This study compared the effects of axial dynamization and staged destabilization on fracture healing. Bilateral midshafts of canine tibiae were osteotomized and fixed with an external fixator. The hind limbs were divided into two groups: the destabilized group in which the fixator's stiffness was progressively reduced over time and the axially dynamized group in which the fixator was axially dynamized. The healed tibiae were tested for 3-point bending in the anteroposterior plane. The biomechanical tests performed 2 months postoperatively revealed that the side with the destabilized fixator was more rigid than the side with the axially dynamized fixator, but the differences were insignificant (P=.20). This study showed staged destabilization of the fixator's stiffness was as effective on the enhancement of fracture healing as axial dynamization.

Assessment of mineral density and atomic content of fracture callus by quantitative computerized tomography

The mineral density and atomic numbers of elements in the periosteal callus and the cortex area of a healing fracture were measured by quantitative computerized tomography (QCT) to obtain accurate information on the mineralization process in rabbit tibia. The mineral density of the periosteal callus was highest on day 15 and decreased gradually throughout the experiment. This was initially detected by QCT, but not with conventional radiography. An apparent decrease in cortical bone density on days 28 and 42 after fracture was observed. Atomic numbers of elements in the cortex remained stable, indicating a possible homeostatic mechanism of mineral preservation at the fracture callus and involved cortical area. QCT may predict density alterations in the fracture callus more accurately than conventional X-ray. Further studies are essential to predict a relationship between mineral density, atomic numbers, and mechanical stability.