title: Load transmission through a healing tibial fracture.
abstract: BACKGROUND
  Fracture healing has been linked to both the magnitude and distribution of mechanical stresses on the healing fracture tissues. However, direct clinical measurement of in vivo tibial axial loading is not possible.
  
  
  METHODS
  Using computed tomography images, force plate data and recorded 3D interfragmentary micromovements, accurate 3D finite element models of a healing human tibial fracture were generated at 7, 10, and 16 weeks post-fracture and used to calculate longitudinal tibial forces and external fixator load-sharing during bilateral stance and walking.
  
  
  RESULTS
  Tibial load-sharing by the fixator decreased significantly as the fracture tissues developed even moderate stiffness, while tibial load increased steadily towards normal.
  
  
  CONCLUSIONS
  Quantitative assessment of the contribution of the external fixator is important as overloading of the callus due to insufficient support has been implicated in the retardation of the healing process.
authors.affiliation: Oxford Orthopaedic Engineering Centre (OOEC), University of Oxford, UK. vinod@intsoph.org
authors.forename: V
authors.initials: V
authors.lastname: Vijayakumar
authors.forename: L
authors.initials: L
authors.lastname: Marks
authors.forename: A
authors.initials: A
authors.lastname: Bremmer-Smith
authors.forename: J
authors.initials: J
authors.lastname: Hardy
authors.forename: T
authors.initials: T
authors.lastname: Gardner
mesh_terms: D000328:Adult; D003198:Computer Simulation; D004548:Elasticity; D020342:Finite Element Analysis; D005592:Fracture Fixation; D017102:Fracture Healing / Q000502:physiology*; D006801:Humans; D008297:Male; D008954:Models, Biological; D011187:Posture; D013314:Stress, Mechanical; D013977:Tibia / Q000503:physiopathology* / Q000601:surgery; D013978:Tibial Fractures / Q000503:physiopathology* / Q000601:surgery; D016896:Treatment Outcome; D016138:Walking; D016474:Weight-Bearing