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Balance Between Mechanical Stability and Mechano-Biology of Fracture Healing Under Volar Locking Plate

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Abstract

The application of volar locking plate (VLP) is promising in the treatment of dorsally comminuted and displaced fracture. However, the optimal balance between the mechanical stability of VLP and the mechanobiology at the fracture site is still unclear. The purpose of this study is to develop numerical models in conjunction with experimental studies to identify the favourable mechanical microenvironment for indirect healing, by optimizing VLP configuration and post-operative loadings for different fracture geometries. The simulation results show that the mechanical behaviour of VLP is mainly governed by the axial compression. In addition, the model shows that, under relatively large gap size (i.e., 3–5 mm), the increase of FWL could enhance chondrocyte differentiation while a large BPD could compromise the mechanical stability of VLP. Importantly, bending moment produced by wrist flexion/extension and torsion moment produced from forearm rotation could potentially hinder endochondral ossification at early stage of healing. The developed model could potentially assist orthopaedic surgeons in surgical pre-planning and designing post-operation physical therapy for treatment of distal radius fractures.

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Acknowledgments

The authors would like to thank Austofix, AOA Research Foundation (Project grant 403), Epworth HealthCare and the University of Melbourne for their support.

Conflict of interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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Authors and Affiliations

  1. Department of Infrastructure Engineering, The University of Melbourne, Parkville, VIC, Australia

    Xuanchi Liu, Saeed Miramini, JinJing Liao & Lihai Zhang

  2. Centre for Limb Lengthening & Reconstruction, Epworth Hospital Richmond, Richmond, VIC, Australia

    Minoo Patel

  3. RMIT Centre for Additive Manufacture, RMIT University, Melbourne, VIC, Australia

    Darpan Shidid

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  1. Xuanchi Liu
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Liu, X., Miramini, S., Patel, M. et al. Balance Between Mechanical Stability and Mechano-Biology of Fracture Healing Under Volar Locking Plate. Ann Biomed Eng 49, 2533–2553 (2021). https://doi.org/10.1007/s10439-021-02815-x

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