Abstract
Tibia fractures are some of the most common long bone fractures. Mending techniques can range based on several indications from nonsurgical to surgical procedures. One such surgical technique is affixing a plate and screws to the bone known as plate osteosynthesis. Through this procedure the fracture is stabilized allowing fracture healing to take place. Fracture healing occurs in stages with heavy overlap and in the early stages a callus is formed in the fracture. The callus bridges the fracture gap and will progressively metamorphose into bone. This evolution is driven by the mechanical environment subjected on the bone. This evolution process has been mathematically formulated by the Stanford Theory of Bone Remodeling; this theory permits a way to track the evolution of the material properties of the region of interests. A computational three dimensional model of the tibia was created in order to run simulations and conduct finite element analysis. Two studies were investigated using the bone remodeling theory and the simulated tibia model as the foundations: in the first study, different plate and screw configurations were investigated to find an optimal configuration that provided stability and improved healing response; in the second study, the addition of man-made defects in the bone were investigated. Both studies were conducted to see how plate configurations affected the osteogenic responses. The man-made defects are the result of provisional external fixation which may be required especially in high energy polytrauma patients, but do, however, create stress risers in the bone prior to permanent fixation. In this study, the osteogenic response of the defects were investigated with response to different distal screw configurations. Overall, both studies showed that increased initial stress in the region of interests lead to better osteogenic responses. Limitations and considerations for future studies are enclosed. These results may lead to improved surgical procedures when it comes to plate osteosynthesis allowing for better prognosis of tibial fractures.