Fracture Healing Monitoring by Impact Tests: Single Case Study of a Fractured Tibia with External Fixator

March 27, 2019

Lorenza MatteiFrancesca Di PuccioStefano Marchetti

Early Access Note:
Early Access articles are new content made available in advance of the final electronic or print versions and result from IEEE’s Preprint or Rapid Post processes. Preprint articles are peer-reviewed but not fully edited. Rapid Post articles are peer-reviewed and edited but not paginated. Both these types of Early Access articles are fully citable from the moment they appear in IEEE Xplore.

Fracture healing monitoring by impact tests


The correct evaluation of the healing process is important to define proper times of fixator dynamization and removal, avoiding refractures. Unfortunately, a quantitative healing assessment is not yet available in clinical practice. The aim of the present study is to prove the feasibility of the mechanical vibration method to assess bone healing in fractures treated with external fixation, in in vivo conditions. The case study was a patient with a tibial fracture treated with a monoaxial fixator. The healing process was monitored for 3 months through a series of 5 impact tests. The pins screwed into the bone were used both to excite and measure vibrations. Fracture healing was quantitatively assessed by estimating the resonant frequencies of the leg. The first frequency increased of about 4% per wk during the observation period. After the hard callus formation (13 wk), also other frequencies increased within the range 1-6% per wk. X-ray observations confirmed the healing progress and proved the method potentiality. Additionally, the vibratory response of the leg after fixator removal was evaluated and resulted characterized by 5 modes in the bandwidth 0-1000 Hz. Results suggest that the vibratory response of a fractured bone treated with external fixation can be a promising indicator for quantitative healing monitoring. The mechanical vibration method could be helpful for reducing X-ray exposure of patients and could be performed more frequently, as desirable for obtaining a more attentive monitoring.



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