机械和电刺激对加速绿枝骨折愈合的影响：来自有限元分析和实验验证的见解

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-07-15 DOI:10.1016/j.jor.2025.07.011

Mohamed Hassan , Enas Fawzi Youssef , Ahmed Rizk Mohamed , A.R. El-Dhaba , Mohamed I. Zineldin , Dina S. Abd Allah

{"title":"机械和电刺激对加速绿枝骨折愈合的影响：来自有限元分析和实验验证的见解","authors":"Mohamed Hassan , Enas Fawzi Youssef , Ahmed Rizk Mohamed , A.R. El-Dhaba , Mohamed I. Zineldin , Dina S. Abd Allah","doi":"10.1016/j.jor.2025.07.011","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Greenstick fractures are common forearm injuries in children, with 75–84 % occurring in the distal third of the radius. Conservative treatments such as detachable braces or plaster backslabs permit early physiotherapy intervention, including muscle activation exercises and electrotherapy. This study investigated the biomechanical and electrophysiological effects on fracture healing to improve bone strength and reduce refracture risk, using finite element analysis (FEA) and experimental validation.</div></div><div><h3>Objective</h3><div>To evaluate the effect of controlled isometric muscle contractions and localized electrical stimulation on fracture healing in pediatric distal radius greenstick fractures, integrating computational modeling with experimental case validation.</div></div><div><h3>Participants and setting</h3><div>The experimental component involved two pediatric patients (aged 8–10 years) diagnosed with distal third greenstick fractures of the radius. Clinical management and data collection were conducted in a physiotherapy outpatient department at a tertiary care hospital.</div></div><div><h3>Methods</h3><div>A 3D model of a radius bone with a distal third greenstick fracture was developed. FEA using ANSYS analyzed strain distribution under isometric contraction of the brachioradialis muscle, with repetitions ranging from 5 to 30. COMSOL Multiphysics also simulated electrical stimulation by applying a 6.25 V potential across the fracture site, assessing displacement and strain alterations. Experimental validation included two pediatric cases: Child A received standard conservative treatment with immobilization, while Child B received local electrical stimulation. Healing progression was quantified by measuring fracture gap reduction by MATLAB-based image analysis.</div></div><div><h3>Results</h3><div>ANSYS simulations indicated that low-repetition (3–5) isometric muscle contractions may enhance callus formation. COMSOL simulations demonstrated a low strain gradient with electrical stimulation, but experimental validation showed a significant 58.8 % reduction in fracture gap area using electric stimulation, compared to 31.8 % with conservative treatment.</div></div><div><h3>Conclusions</h3><div>Applying controlled isometric mechanical loading and electrical stimulation may reduce the fracture gap in greenstick distal radius fractures, accelerate healing and recovery. Future studies should explore direct current electrical stimulation (DCES) for potentially more robust effects on bone remodeling.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"67 ","pages":"Pages 308-317"},"PeriodicalIF":1.5000,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effects of mechanical and electrical stimulation on accelerating greenstick fracture Healing: Insights from finite element analysis and experimental validation\",\"authors\":\"Mohamed Hassan , Enas Fawzi Youssef , Ahmed Rizk Mohamed , A.R. El-Dhaba , Mohamed I. Zineldin , Dina S. Abd Allah\",\"doi\":\"10.1016/j.jor.2025.07.011\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Greenstick fractures are common forearm injuries in children, with 75–84 % occurring in the distal third of the radius. Conservative treatments such as detachable braces or plaster backslabs permit early physiotherapy intervention, including muscle activation exercises and electrotherapy. This study investigated the biomechanical and electrophysiological effects on fracture healing to improve bone strength and reduce refracture risk, using finite element analysis (FEA) and experimental validation.</div></div><div><h3>Objective</h3><div>To evaluate the effect of controlled isometric muscle contractions and localized electrical stimulation on fracture healing in pediatric distal radius greenstick fractures, integrating computational modeling with experimental case validation.</div></div><div><h3>Participants and setting</h3><div>The experimental component involved two pediatric patients (aged 8–10 years) diagnosed with distal third greenstick fractures of the radius. Clinical management and data collection were conducted in a physiotherapy outpatient department at a tertiary care hospital.</div></div><div><h3>Methods</h3><div>A 3D model of a radius bone with a distal third greenstick fracture was developed. FEA using ANSYS analyzed strain distribution under isometric contraction of the brachioradialis muscle, with repetitions ranging from 5 to 30. COMSOL Multiphysics also simulated electrical stimulation by applying a 6.25 V potential across the fracture site, assessing displacement and strain alterations. Experimental validation included two pediatric cases: Child A received standard conservative treatment with immobilization, while Child B received local electrical stimulation. Healing progression was quantified by measuring fracture gap reduction by MATLAB-based image analysis.</div></div><div><h3>Results</h3><div>ANSYS simulations indicated that low-repetition (3–5) isometric muscle contractions may enhance callus formation. COMSOL simulations demonstrated a low strain gradient with electrical stimulation, but experimental validation showed a significant 58.8 % reduction in fracture gap area using electric stimulation, compared to 31.8 % with conservative treatment.</div></div><div><h3>Conclusions</h3><div>Applying controlled isometric mechanical loading and electrical stimulation may reduce the fracture gap in greenstick distal radius fractures, accelerate healing and recovery. Future studies should explore direct current electrical stimulation (DCES) for potentially more robust effects on bone remodeling.</div></div>\",\"PeriodicalId\":16633,\"journal\":{\"name\":\"Journal of orthopaedics\",\"volume\":\"67 \",\"pages\":\"Pages 308-317\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-07-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of orthopaedics\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0972978X25002703\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of orthopaedics","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0972978X25002703","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

摘要

背景：绿棒骨折是儿童前臂常见的损伤，75 - 84%发生在桡骨远端三分之一。保守治疗如可拆卸支架或石膏背板允许早期物理治疗干预，包括肌肉激活练习和电疗。本研究通过有限元分析（FEA）和实验验证，探讨了生物力学和电生理对骨折愈合的影响，以提高骨强度和降低再骨折风险。目的采用计算模型和病例验证相结合的方法，探讨可控等长肌肉收缩和局部电刺激对小儿桡骨远端绿棒骨折愈合的影响。实验对象和背景包括两名儿童患者（年龄8-10岁），诊断为桡骨远端第三绿枝骨折。临床管理和数据收集在一家三级保健医院的物理治疗门诊进行。方法建立桡骨远端第三节绿枝骨折的三维模型。采用ANSYS进行有限元分析，分析了肱桡肌等距收缩时的应变分布，收缩次数为5 ~ 30次。COMSOL Multiphysics还通过在裂缝部位施加6.25 V电位来模拟电刺激，评估位移和应变变化。实验验证包括两例儿童病例：儿童A接受标准保守治疗并固定，而儿童B接受局部电刺激。通过基于matlab的图像分析测量骨折间隙缩小来量化愈合进展。结果sansys模拟表明，低重复（3-5）等长肌肉收缩可促进骨痂形成。COMSOL模拟显示，电刺激的应变梯度较低，但实验验证表明，电刺激的裂缝间隙面积减少了58.8%，而保守治疗的裂缝间隙面积减少了31.8%。结论应用可控的等距机械载荷和电刺激可减小绿枝桡骨远端骨折的骨折间隙，加速愈合和恢复。未来的研究应该探索直流电刺激（DCES）对骨重塑的潜在更强大的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Effects of mechanical and electrical stimulation on accelerating greenstick fracture Healing: Insights from finite element analysis and experimental validation

Background

Greenstick fractures are common forearm injuries in children, with 75–84 % occurring in the distal third of the radius. Conservative treatments such as detachable braces or plaster backslabs permit early physiotherapy intervention, including muscle activation exercises and electrotherapy. This study investigated the biomechanical and electrophysiological effects on fracture healing to improve bone strength and reduce refracture risk, using finite element analysis (FEA) and experimental validation.

Objective

To evaluate the effect of controlled isometric muscle contractions and localized electrical stimulation on fracture healing in pediatric distal radius greenstick fractures, integrating computational modeling with experimental case validation.

Participants and setting

The experimental component involved two pediatric patients (aged 8–10 years) diagnosed with distal third greenstick fractures of the radius. Clinical management and data collection were conducted in a physiotherapy outpatient department at a tertiary care hospital.

Methods

A 3D model of a radius bone with a distal third greenstick fracture was developed. FEA using ANSYS analyzed strain distribution under isometric contraction of the brachioradialis muscle, with repetitions ranging from 5 to 30. COMSOL Multiphysics also simulated electrical stimulation by applying a 6.25 V potential across the fracture site, assessing displacement and strain alterations. Experimental validation included two pediatric cases: Child A received standard conservative treatment with immobilization, while Child B received local electrical stimulation. Healing progression was quantified by measuring fracture gap reduction by MATLAB-based image analysis.

Results

ANSYS simulations indicated that low-repetition (3–5) isometric muscle contractions may enhance callus formation. COMSOL simulations demonstrated a low strain gradient with electrical stimulation, but experimental validation showed a significant 58.8 % reduction in fracture gap area using electric stimulation, compared to 31.8 % with conservative treatment.

Conclusions

Applying controlled isometric mechanical loading and electrical stimulation may reduce the fracture gap in greenstick distal radius fractures, accelerate healing and recovery. Future studies should explore direct current electrical stimulation (DCES) for potentially more robust effects on bone remodeling.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.