This PhD thesis work establishes a concept for developing a measuring device to monitor the healing of distal radial fractures treated with external fixation. This device will be used to determine the safe time for the removal of external fixators. Original research is presented following advanced studies of technical literature on biomechanics, with focus on external fixation. A quantitative and objective method to assess the healing of the fracture presents the opportunity to overcome the necessity for a six-week treatment and introduces the possibility of being able to remove the external fixator as soon as the callus reaches a safe value of rigidity. The axial rigidity of the callus has been chosen as the measure to monitor fracture healing. The measuring device has been specifically designed to work on human patients. A technique has been developed and tested to process the data recorded by the device. Measurements were taken with the external fixator in place (i.e., indirect measurements of callus rigidity), allowing the mechanical assessment of the callus to be performed during the initial stage of healing (i.e., a few days after surgery) with no risk for the healing process of the fracture. The measuring device developed has been tested on patients included in the pilot study. Encouraging results have been obtained, which confirm that the device can be used to monitor the fracture healing process. The results from the measuring device can be interpreted to distinguish different stages during healing (i.e., initial stage, medium stage and final stage). Based on the results obtained from the 30 patients included in the pilot study a preliminary safe value of callus rigidity is observed. The outcome from the measuring device has been compared with the conventional clinical methods to assess fracture healing (X-ray assessment and callus density). The aim of this research was to provide a quantitative and objective instrument to measure the healing of distal radial fractures in order to determine the correct time for the removal of external fixators. A rational investigation has been conducted based on the study of fracture healing, fracture treatments, previous measuring devices and techniques. Engineering methods have been applied to the field of orthopaedic medicine.

INVESTIGATION OF A DEVICE FOR MEASUREMENT OF FRACTURE HEALING IN THE DISTAL RADIUS

TETI, ROBERTO
2005

Abstract

This PhD thesis work establishes a concept for developing a measuring device to monitor the healing of distal radial fractures treated with external fixation. This device will be used to determine the safe time for the removal of external fixators. Original research is presented following advanced studies of technical literature on biomechanics, with focus on external fixation. A quantitative and objective method to assess the healing of the fracture presents the opportunity to overcome the necessity for a six-week treatment and introduces the possibility of being able to remove the external fixator as soon as the callus reaches a safe value of rigidity. The axial rigidity of the callus has been chosen as the measure to monitor fracture healing. The measuring device has been specifically designed to work on human patients. A technique has been developed and tested to process the data recorded by the device. Measurements were taken with the external fixator in place (i.e., indirect measurements of callus rigidity), allowing the mechanical assessment of the callus to be performed during the initial stage of healing (i.e., a few days after surgery) with no risk for the healing process of the fracture. The measuring device developed has been tested on patients included in the pilot study. Encouraging results have been obtained, which confirm that the device can be used to monitor the fracture healing process. The results from the measuring device can be interpreted to distinguish different stages during healing (i.e., initial stage, medium stage and final stage). Based on the results obtained from the 30 patients included in the pilot study a preliminary safe value of callus rigidity is observed. The outcome from the measuring device has been compared with the conventional clinical methods to assess fracture healing (X-ray assessment and callus density). The aim of this research was to provide a quantitative and objective instrument to measure the healing of distal radial fractures in order to determine the correct time for the removal of external fixators. A rational investigation has been conducted based on the study of fracture healing, fracture treatments, previous measuring devices and techniques. Engineering methods have been applied to the field of orthopaedic medicine.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11588/10331
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