To date, several studies have implied the importance of early stage mechanical stability in the bone fracture healing process. This study aimed at finding a correlation between the predicted different tissue phenotypes in the early stages of healing and the ultimate healing outcome. For this purpose, the process of fracture healing was numerically simulated employing an axisymmetric bi-phasic finite element (FE) model for three initial gap sizes of 1, 3 and 6[Formula: see text]mm and four initial interfragmentary strains (IFS) of 7%, 11%, 15% and 19%. The model was validated with experimental and other numerical studies from the literature. Results of this study showed that the amount of cartilage and fibrous tissue observed in the early stage after fracture can be used to qualitatively assess the outcome of complete bone healing process. Greater amount of cartilage in early stage of healing process yielded faster callus maturation, and delayed maturation of callus was predicted in the case of high fibrous tissue production. Results of this study can be used to provide an estimation of the performance of different fixation systems by considering the amounts of cartilage and fibrous tissues observed in the early stage of healing.
Computational Simulation of the Influence of Mechanical Stability on Growth Factors Activities during Bone Fracture Healing