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首页> 外文期刊>Australasian physical & engineering sciences in medicine >The relationship between interfragmentary movement and cell differentiation in early fracture healing under locking plate fixation
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The relationship between interfragmentary movement and cell differentiation in early fracture healing under locking plate fixation

机译：锁定钢板固定下骨折早期愈合过程中节间运动与细胞分化的关系

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Interfragmentary movement (IFM) at the fracture site plays an important role in fracture healing, particularly during its early stage, via influencing the mechanical microenvironment of mesenchymal stem cells within the fracture callus. However, the effect of changes in IFM resulting from the changes in the configuration of locking plate fixation on cell differentiation has not yet been fully understood. In this study, mechanical experiments on surrogate tibia specimens, manufactured from specially formulated polyurethane, were conducted to investigate changes in IFM of fractures under various locking plate fixation configurations and loading magnitudes. The effect of the observed IFM on callus cell differentiation was then further studied using computational simulation. We found that during the early stage, cell differentiation in the fracture callus is highly influenced by fracture gap size and IFM, which in turn, is highly sensitive to locking plate fixation configuration. The computational model predicted that a small gap size (e.g. 1 mm) under a relatively flexible configuration of locking plate fixation (larger bone-plate distances and working lengths) could experience excessive strain and fluid flow within the fracture site, resulting in excessive fibrous tissue differentiation and delayed healing. By contrast, a relatively flexible configuration of locking plate fixation was predicted to improve cartilaginous callus formation and bone healing for a relatively larger gap size (e.g. 3 mm). If further confirmed by animal and human studies, the research outcome of this paper may have implications for orthopaedic surgeons in optimising the application of locking plate fixations for fractures in clinical practice.
机译：骨折部位的碎片间运动（IFM）通过影响骨折愈伤组织内的间充质干细胞的机械微环境，在骨折愈合中起着重要作用，尤其是在其早期阶段。但是，由于锁板固定构型的改变而引起的IFM改变对细胞分化的影响尚未完全了解。在这项研究中，对由特殊配制的聚氨酯制成的替代胫骨标本进行了机械实验，以研究在各种锁定板固定配置和载荷大小下骨折的IFM的变化。然后使用计算模拟进一步研究观察到的IFM对愈伤组织细胞分化的影响。我们发现，在早期阶段，骨折间隙的大小和IFM对骨折骨us中的细胞分化有很大的影响，进而对锁定板固定结构高度敏感。该计算模型预测，在锁定板固定的相对灵活配置（较大的骨板距离和工作长度）下，较小的间隙尺寸（例如1 mm）可能会在骨折部位内经受过度的应变和流体流动，从而导致过多的纤维组织分化和延迟愈合。相比之下，锁定板固定的相对灵活的构型预计将在相对较大的间隙尺寸（例如3mm）下改善软骨愈伤组织的形成和骨愈合。如果得到动物和人体研究的进一步证实，则本文的研究结果可能对整形外科医生在临床实践中优化锁定钢板固定在骨折中的应用具有重要意义。

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