Computational Simulation of Mechanical Microenvironment of Early Stage of Bone Healing under Locking Compression Plate with Dynamic Locking Screws

Abstract

It is well known that bone healing outcomes highly depend on the mechanical microenvironment of the fracture site, and a certain degree of interfragmentary movement (IFM) is essential for indirect (i.e. natural) bone healing. The application of locking compression plate (LCP) internal fixation in the treatment of bone fracture is a common practice which leads to early mobility and full function of the fractured extremity. However should the fixation configuration be too stiff, it might result in delayed healing or asymmetric tissue development across the fracture site due to the fact that IFM in near cortex area is too small to promote healing. Dynamic locking screw (DLS) has been recently designed to tackle this problem by reducing the stiffness of LCP fixation. However, the actual mechano-regulation mechanisms in which DLS uses to regulate the healing process are still not fully understood. The objective of this paper is to develop a computational model to understand the change of mechanical microenvironment of fracture site under LCP with dynamic locking screw in comparison to standard locking screw, and how this change could potentially regulate tissue development within the fracture callus during the healing process.Keywords: bone healing, locking compression plate, dynamic locking screw, finite element modelling