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Technical Brief

Enhancement of Long Bone Fracture Healing by Local Soft Tissue Compression1

[+] Author and Article Information
Ernest C. Chisena

St. Catherine of Siena Medical Center &
VA Medical Center,
Northport, NY 11768

Jahangir S. Rastegar

Mechanical Engineering Department,
Stony Brook University,
Stony Brook, NY 11794-2300

Robert S. Chisena

Department of Mechanical and Nuclear Engineering,
Penn State University,
University Park, PA 16802

Accepted and presented at the Design of Medical Devices Conference (DMD2014), Minneapolis, MN, April 7-10, 2014.DOI: 10.1115/1.4026996

Manuscript received February 21, 2014; final manuscript received March 3, 2014; published online April 28, 2014. Editor: Arthur G. Erdman.

J. Med. Devices 8(2), 020934 (Apr 28, 2014) (2 pages) Paper No: MED-14-1025; doi: 10.1115/1.4026996 History: Received February 21, 2014; Revised March 03, 2014

Endochondral fracture healing, the process in which callus bridges a fracture, can be enhanced using a brace with a deforming element. This deforming element acts to locally increase pressure at the fracture site. In this paper, we describe a bracing device, which has the capability of controlling blood flow in targeted regions of an extremity. Controlling the blood flow around a fracture site induces a mechanism that enhances fracture healing. We hypothesize that, since local oxygen tension is lowered by means of controlling the blood flow at the fracture site, fracture healing is accelerated and bony union is more likely. Using the results of several previous studies, we will show that increased mechanical pressure in the soft tissues over the fracture site enhances fracture healing.

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References

Knighton, D., Silver, I., and Hunt, T. K., 1981, “Regulation of Wound Healing Angiogenesis-Effect of Oxygen Gradients and Inspired Oxygen Concentration,” Surgery, 90(2), pp. 262–270.
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Chisena, E. C., and Chisena, R. S., “New Approach to Treating Metastatic Adenocarcinoma of Long Bones,” available at: http://www.scribd.com/doc/115362070/New-Approch-to-Treating-Metastatic-Adenocarcinoma-of-Long-Bones
Morr, S., Chisena, E. C., Tomin, E., Mangino, M., and Lane, J. M., 2010, “Local Soft Tissue Compression Enhances Fracture Healing in a Rabbit Fibula,” HSS J., 6(1), pp. 43–48. [CrossRef]
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Brighton, C. T., and Heppenstall, R. B., 1971, “Oxygen Tension on Zones of the Epiphyseal Plate, the Metaphysis, and Diaphysis: An In Vitro and In Vivo Study in Rats and Rabbits,” J. Bone Joint Surg., 53(4), pp. 719–728.
Murphy, P. J., 2005, “The Fetal Circulation,” Contin. Edu. Anaesth., Crit. Care Pain, 5(4), pp. 107–112. [CrossRef]
Shah, S., 2010, “Hypoxia in Tumor Angiogenesis and Metastasis: Evaluation of VEGF and MMP Over-Expression and Down-Regulation of HIF-1a With RNAi in Hypoxic Tumor Cells,” Master's thesis, Northwestern University, Evanston, IL, Paper No. 18, available at: http://hdl.handle.net/2047/d20000811

Figures

Grahic Jump Location
Fig. 1

(a) Schematic of bracing device; (b) brace with movable deforming element (arrow). The deforming element is fixed over the apex of the fracture to ensure alignment and reduce blood flow at the fracture site.

Grahic Jump Location
Fig. 2

(a) and (b): deforming element compresses the soft tissue component of pathologic fracture

Grahic Jump Location
Fig. 3

Comparison of rabbit femurs with and without compression at the fracture site

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