Numerical evaluation of scaffolds as a method to restore continuity of a long bone

Purpose

In case of necessity of removing a bone fragment, the process of restoring bone continuity relies on the use of bone grafts or bone plates as osteosynthesis methods. These approaches are characterised by several disadvantages, such as significant changes in load transfer method through the bone. Recently, scaffolds emerged as potentially more efficient method in restoring bone continuity. In this paper, an attempt was made to validate the correctness of this statement.

Materials and methods

Three lengths of bone defects were selected for the analysis: 35, 45 and 55 mm, located in the lower, middle and upper section of femur diaphysis. The following methods of restoring bone continuity were evaluated: 1 plate, 2 parallel plates, 1 plate and scaffold, 2 parallel plates and scaffold. Simulations of the forces generated during human gait cycle were performed. The evaluated parameters obtained were: maximal and average stresses, strain energy density as well as percentage changes in values of these parameters in relation to the values obtained for intact bone in its selected zones.

Results

Studies have shown that the best method of restoring bone continuity is to use a single plate with a scaffold. The stress distribution obtained by this method had the highest similarities to the one obtained for intact bone model in terms of load transfer as well as maximal stresses values obtained.

Conclusions

The study validated the statement that the use of a scaffold to restore bone continuity is potentially more efficient method than conventional approaches.