PSI - Issue 5

Andreia Flores et al. / Procedia Structural Integrity 5 (2017) 34–39 Andreia Flores et al./ Structural Integrity Procedia 00 (2017) 000 – 000 ndreia lores et al./ Structural Integrity rocedia 00 (2017) 000 – 000

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The purpose of this work is twofold: primarily, to study the consolidation process using different immobilization systems, and secondarily, to explore the necessary time for bone consolidation by recording the relevant mechanical parameters time story. © 2017 The Authors. Published by Elsevier B.V. Peer-review under responsibility of the Scientific Committee of ICSI 2017. r is t f l : ri aril , t st t e c s li ati r cess si iffere t i ilizati s ste s, a sec aril , t e l re t e ecessar ti e f r e c s li ati rec r i t e rele a t ec a ical ara eters ti e st r . 7 The Authors. Published by Elsevier B.V. Peer-review under responsibilit of t e cie tific ittee f I I . © 2017 The Authors. Published by Elsevier B.V. Peer-review under responsibility of the Scientific Committee of ICSI 2017 e r se f t is

Keywords: Bone fracture, Consolidation Process, Immobilization system, Internal/external fixation; time healing ey ords: one fracture, onsolidation rocess, I obilization syste , Internal/external fixation; ti e healing

1. Introduction . I t ti

The living tissues of human body have different properties and function, but they all react to loads and ensure the support of the remaining tissues of human body, such as muscle, ligaments or tendons [1]. However, bones are an important component of the skeleton system providing protection and structure, and supporting mobility. Nevertheless, its mechanical integrity can be compromised to traumatic fractures or injuries of the bone tissue which requires operative treatments and immobilization. There are many fixation devices available for fracture immobilization that can be classified according to its use as external and internal fixators. It is expected that the fixation device provides sufficient mechanical stability during the initial phase and some load transfer during healing. The fixation stability is an important factor on healing outcome and the degree of stability is determined by the stiffness of the fixator. However, there several aspects about the fracture and immobilization systems that are still unknown, namely on the influence of the mechanical stimulus on bone cells proliferation and differentiation. The main objective of this review is to compile information on the different types of immobilization systems, the features of the consolidation process each one fosters, so that observed healing times can be studied as a result of fixators types and applied load patterns as previously stated. li i tiss s f iff r t r rti s f ti , t t ll r t t l s s r t s rt f t r i i tiss s f , s s s l , li ts r t s [ ]. r, bones are an i rt t t f t s l t s st r i i r t ti str t r , s rti ilit . rt l ss, its i l i t rit r is t tr ti fr t r s r i j ri s f t tiss i r ir s operative treatments and immobilizati . r r fi ti i s il l f r fr t r i ili ti t t l ssifi r i t its s s t r l i t r l fi t rs. It is t t t t fi ti i r i s s ffi i t i l st ilit ri t i iti l s s l tr sf r during healing. The fixation stabilit is i rt t f t r li t t r f st ilit is t r i t stiff ss f t fi t r. r, t r s r l s ts t t fr t r i ili ti s st s t t r still , l t i fl f t i l sti l s lls r lif r ti iff r ti ti . i j ti f t is r i is t il i f r ti t iff r t t s f i ili ti s st s, t f t r s f t s li ti r ss f st rs, s t t s r li ti s st i s r s lt f fixators types and applied load patterns as previously stated. To provide a comprehensive overview on fracture consolidation and their process, a thorough literature review was carried out in the present work on bone fracture, consolidation, fracture immobilization and internal/external fixation. The next search stage was centered on a few of these, considered more relevant for the matter and focused on specific aspects of the work, namely those reported in this work. But, primarily and to underlay the base knowledge to better understand the influence of the fixators types and their loading characteristics, one has to understand the bone consolidation mechanisms and all its phases, as much as possible. The most common causes of fracture are trauma, osteoporosis and excessive load, but there are several of other factors that can promote bone fracture. There are different approaches to perform the bone fracture immobilization which include: external fixation; internal fixation; intramedullary nailing, and; plate fixation. Such methods are not all appropriate for every type of fracture, for instance, diagonal femur fractures should be treated with intramedullary nailing. The treatment method is normally selected according to the following principles: restoration of alignment, rotation and length; preservation of the blood supply to aid union and prevent infection; and finally, the rehabilitation of the extremity and the patient [2]. Accordingly, the methods for fracture immobilization mean time for healing are different, as represented in Table 1. However, the fixation method is not the unique aspect that influences healing time. r i fr t r s li ti t ir r ss, t r lit r t r r i s rri t i t r s t r fr t r , s li ti , fr t r i ili ti i t r l/ t r l fi ti . t s r st s t r f f t s , si r r r l t f r t tt r f s s ifi s ts f t r , l t s r rt i t is r . t, ri ril t rl t s l t tt r rst t i fl f t fi t rs t s t ir l i r t risti s, s t rst t consolidation mechanisms and all its phases, as much as possible. st s s f fr t r r tr , st r sis ssi l , t t r r s ral of other f t rs t t r t fr t r . r r iff r t r s t rf r t fr t r i ili ti i i l : t r l fi ti ; i t r l fi ti ; i tr ll r ili , ; l t fi ti . t s r t ll r ri t f r r t f fr t r , f r i st , i l f r fr t r s s l tr t it i tr ll r ili . tr t t t is r ll s l t r i t t f ll i ri i l s: r st r ti f li t, r t ti l t ; r s r ti f t l s l t i i r t i f ti ; fi ll , t r ilit ti f t extremity and the patient [2]. Accordingly, the methods for fracture immobilization mean time for healing are iff r t, s r r s t i l . r, t fi ti t is t t i s t t t i fl s li ti . . r i r si 2. Methods t s