A bone healing assessment is crucial for the successful treatment of fractures, particularly in terms of the timing of support devices. However, in clinical practice, this assessment is only made qualitatively through bone manipulation and X-rays, and hence cannot be repeated as often as might be required. The present study reconsiders the quantitative method of frequency response analysis for healing assessments, and specifically for fractures treated with an external fixator. The novelty consists in the fact that bone excitation and response are achieved through fixator pins, thus overcoming the problem of transmission through soft-tissues and their damping effect. The main objective was to develop and validate a test procedure in order to characterize the treated bone. More than 80 tests were performed on a tibia phantom alone, a phantom with pins, and a phantom with a complete fixator. Different excitation techniques and input–output combinations were compared. The results demonstrated the effectiveness of a procedure based on impact tests using a micro-hammer. Pins and fixator were demonstrated to influence the frequency response of the phantom by increasing the number of resonant frequencies. This procedure will be applied in future studies to monitor healing both in in vitro and in vivo conditions.
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Similar content being viewed by others Explore related subjectsDiscover the latest articles and news from researchers in related subjects, suggested using machine learning. ReferencesAugat, P., M. Faschingbauer, K. Seide, K. Tobita, S. A. Callary, L. B. Solomon, et al. Biomechanical methods for the assessment of fracture repair. Injury. 45(Suppl 2):S32–S38, 2014.
Bediz, B., H. N. Ozguven, and F. Korkusuz. Vibration measurements predict the mechanical properties of human tibia. Clin. Biomech. 25:365–371, 2010.
Benirschke, S. K., H. Mirels, D. Jones, and A. F. Tencer. The use of resonant frequency measurements for the noninvasive assessment of mechanical stiffness of the healing tibia. J. Orthop. Trauma 7:64–71, 1993.
Biomechanical test materials. http://www.sawbones.com. 2016.
Checketts, R. G., and C. F. Young. External fixation of diaphyseal fractures of the tibia. Curr. Orthop. 17:176–189, 2003.
Claes, L. E., and J. L. Cunningham. Monitoring the mechanical properties of healing bone. Clin. Orthop. Relat. Res. 467:1964–1971, 2009.
Cunningham, J. L., J. Kenwright, and C. J. Kershaw. Biomechanical measurement of fracture healing. J. Med. Eng. Technol. 14:92–101, 1990.
Ewins, D. J. Modal Testing: Theory, Practice and Application (2nd ed.). Baldock: Reserach Studies Press LTD, 2000.
Fragomen, A. T., and S. R. Rozbruch. The mechanics of external fixation. HSS J. 3:13–29, 2007.
Giannoudis, P. V., T. A. Einhorn, and D. Marsh. Fracture healing: the diamond concept. Injury. 38(Suppl 4):S3–S6, 2007.
Hoffmann II MRI external fixation system. http://www.stryker.com. 2016.
Marsell, R., and T. A. Einhorn. The biology of fracture healing. Injury. 42:551–555, 2011.
Morshed, S. Current options for determining fracture union. Adv. Med. 2014:708574, 2014.
Nakatsuchi, Y., A. Tsuchikane, and A. Nomura. The vibrational mode of the tibia and assessment of bone union in experimental fracture healing using the impulse response method. Med. Eng. Phys. 18:575–583, 1996.
Nikiforidis, G., A. Bezerianos, A. Dimarogonas, and C. Sutherland. Monitoring of fracture healing by lateral and axial vibration analysis. J. Biomech. 23:323–330, 1990.
Nokes, L. D. M. The use of low-frequency vibration measurement in orthopaedics. Proc. Inst. Mech. Eng. Part H 213:271–290, 1999.
Ong, W. H., W. K. Chiu, M. Russ, and Z. K. Chiu. Integrating sensing elements on external fixators for healing assessment of fractured femur. Struct. Control Health Monit. 2016.
Tower, S. S., R. K. Beals, and P. J. Duwelius. Resonant frequency analysis of the tibia as a measure of fracture healing. J. Orthop. Trauma 7:179, 1993.
Wong, L. C., W. K. Chiu, M. Russ, and S. Liew. Review of techniques for monitoring the healing fracture of bones for implementation in an internally fixated pelvis. Med. Eng. Phys. 34:140–152, 2012.
The authors gratefully acknowledge Dr. Paolo Neri for providing the electromagnetic shaker, and Dr. Paolo Parchi for his suggestions regarding the focus of the research activity.
Author information Authors and AffiliationsDepartment of Civil and Industrial Engineering, University of Pisa, Largo Lucio Lazzarino 2, 56126, Pisa, Italy
Lorenza Mattei, Antonia Longo, Francesca Di Puccio & Enrico Ciulli
Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
Stefano Marchetti
Correspondence to Lorenza Mattei.
Additional informationAssociate Editor Mona Kamal Marei oversaw the review of this article.
About this article Cite this articleMattei, L., Longo, A., Di Puccio, F. et al. Vibration Testing Procedures for Bone Stiffness Assessment in Fractures Treated with External Fixation. Ann Biomed Eng 45, 1111–1121 (2017). https://doi.org/10.1007/s10439-016-1769-1
Received: 10 August 2016
Accepted: 26 November 2016
Published: 19 December 2016
Issue Date: April 2017
DOI: https://doi.org/10.1007/s10439-016-1769-1
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