title: An electronically instrumented internal fixator for the assessment of bone healing.
abstract: OBJECTIVE
  The monitoring of fracture healing is a complex process. Typically, successive radiographs are performed and an emerging calcification of the fracture area is evaluated. The aim of this study was to investigate whether different bone healing patterns can be distinguished using a telemetric instrumented femoral internal plate fixator.
  
  
  METHODS
  An electronic telemetric system was developed to assess bone healing mechanically. The system consists of a telemetry module which is applied to an internal locking plate fixator, an external reader device, a sensor for measuring externally applied load and a laptop computer with processing software. By correlation between externally applied load and load measured in the implant, the elasticity of the osteosynthesis is calculated. The elasticity decreases with ongoing consolidation of a fracture or nonunion and is an appropriate parameter for the course of bone healing. At our centre, clinical application has been performed in 56 patients suffering nonunion or fracture of the femur.
  
  
  RESULTS
  A total of 39 cases of clinical application were reviewed for this study. In total, four different types of healing curves were observed: fast healing; slow healing; plateau followed by healing; and non-healing.
  
  
  CONCLUSIONS
  The electronically instrumented internal fixator proved to be valuable for the assessment of bone healing in difficult healing situations. Cost-effective manufacturing is possible because the used electronic components are derived from large-scale production. The incorporation of microelectronics into orthopaedic implants will be an important innovation in future clinical care.Cite this article: B. Kienast, B. Kowald, K. Seide, M. Aljudaibi, M. Faschingbauer, C. Juergens, J. Gille. An electronically instrumented internal fixator for the assessment of bone healing. Bone Joint Res 2016;5:191-197. DOI: 10.1302/2046-3758.55.2000611.
authors.affiliation: BG Trauma Hospital Hamburg, Bergedorfer Str. 10, 21033 Hamburg, Germany b.kienast@bgk-hamburg.de.
authors.forename: B
authors.initials: B
authors.lastname: Kienast
authors.affiliation: BG Trauma Hospital Hamburg, Bergedorfer Str. 10, 21033 Hamburg, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Kowald
authors.affiliation: BG Trauma Hospital Hamburg, Bergedorfer Str. 10, 21033 Hamburg, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Seide
authors.affiliation: BG Trauma Hospital Hamburg, Bergedorfer Str. 10, 21033 Hamburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Aljudaibi
authors.affiliation: BG Trauma Hospital Hamburg, Bergedorfer Str. 10, 21033 Hamburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Faschingbauer
authors.affiliation: BG Trauma Hospital Hamburg, Bergedorfer Str. 10, 21033 Hamburg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Juergens
authors.affiliation: BG Trauma Hospital Hamburg, Bergedorfer Str. 10, 21033 Hamburg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Gille
keywords: Fracture healing; Instrumented implant; Locking plate; Nonunion; Telemetry