The literature on bone growth, fracture healing, fracture treatment and the effects of forces and movements on these is reviewed. Some methods of assessing the progress of fracture union are considered. The conclusion from this is that a fracture movement transducer is needed for use on an external fracture fixator, and the design criteria are outlined. The possible types of transducers are considered and a system of light falling on lateral effect photodetectors was used. The linearizing algorithms applicable to the employed detectors are discussed and tested. The electronic circuits were designed and revised, initially to produce a reasonable power consumption, and then to give a system with reduced noise levels and improved linearity. Isolation amplifiers were required to prevent leakage currents reaching the patient from the mains powered computer. The algorithms relating the movements of the transducer to the movements at the fracture site were derived, including the use of elasticity theory to calculate the bending of the fixator pins. The engineering descriptions of the patient tests and the methods of calculating the fracture stiffness are considered. The transducer was calibrated, and consideration was given to the effect of the fixator pins loosening in the bone. Seven patients, all with tibial fractures, six injured in road traffic accidents and one footballing injury, were tested and their clinical histories were reviewed. Comparison was made between the results from the displacement transducer and a strain gauge transducer, related to the clinical history. It is concluded that this transducer, although useful, has more relevance as a research than as a clinical tool, but that further tests would lead to increased further understanding of fracture healing.

published_or_final_version / Orthopaedic Surgery / Master / Master of Philosophy

published_or_final_version / Nursing Studies / Master / Master of Nursing

Thesis (Ph. D.)--University of Washington, 1999. / Vita. Includes bibliographical references (leaves 42-48).

Bone fracture, particularly that occurring in osteoporotic conditions, has become a major health issue. Fracture healing is a well-orchestrated regenerative process, the enhancement of which has been one of the major goals in fracture management. Low-magnitude high-frequency vibration (LMHFV) is osteogenic for intact bone and beneficial for limb blood circulation, which implies a potential of enhancement for fracture healing. Three parts of the experiments were conducted in this study to test the hypothesis that LMHFV would accelerate fracture healing by promoting chondrogenesis, endochondral ossification, and remodeling in both normal and osteoporotic bones. / Part I study. Three-month-old female SD rats underwent closed femoral fracture and were randomized into either vibration group (VG-I, 35Hz, 0.3g, 20min/day, 5days/week) or sham-treated control group (CG-I). Femora were harvested at 1, 2 and 4 weeks for micro-CT analysis, histomorphometry, and mechanical testing. Part II study. Osteoporotic model was established in nine-month-old SD rats after three months of inducement following ovariectomy. Similar grouping (VG-II and CG-II) and treatment regimes were performed after fracture, with the femora harvested at 2, 4 and 8 weeks for assessments like those in the Part I study. Part III study. After fracture, 3-month-old female SD rats were grouped (VG-III and CG-III) and treated as in the Part I study. At 1, 2 and 4 weeks, femora were collected for gene quantification (Col-1, Col-2, BMP-2, VEGF, and TGF-beta1) using real-time PCR. Type I and II collagens were located immunochemically in histological sections. / Results of the Part I and II studies demonstrated that LMHFV promoted callus formation (together with chondrogenesis), mineralization (endochondral ossification), and remodeling, which led to faster healing and better mechanical outcomes in both normal and osteoporotic fractures. In molecular level, the effect of LMHFV was reflected by the stimulation of chondrogenesis and osteogenesis related matrix collagen formation and growth factor expression. The molecular data echo Part I and II findings well. This study proved that LMHFV accelerated fracture healing by promoting chondrogenesis, endochondral ossification, and remodeling in both normal and osteoporotic bones, and indicated great potential of its future clinical application on fracture healing. / Shi, Hongfei. / Adviser: Kwok-Sui Leung. / Source: Dissertation Abstracts International, Volume: 70-06, Section: B, page: 3422. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 180-201). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Chow, Dick Ho Kiu. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 93-103). / Abstracts in English and Chinese. / Abstract --- p.ii / Publications --- p.vii / Acknowledgement --- p.viii / Table of Contents --- p.x / List of Figures --- p.xiv / List of Tables --- p.xv / List of Abbreviations --- p.xvii / Chapter 1 --- Introduction --- p.1 / Chapter 1.1 --- Bone and its Cellular Components --- p.1 / Chapter 1.1.1 --- Cellular Components of Bone --- p.1 / Chapter 1.1.2 --- Macroscopic Structure --- p.4 / Chapter 1.1.3 --- Microscopic Structure --- p.4 / Chapter 1.2 --- Fracture Healing --- p.5 / Chapter 1.2.1 --- Inflammation --- p.6 / Chapter 1.2.2 --- Soft Callus Formation --- p.6 / Chapter 1.2.3 --- Hard Callus Formation --- p.7 / Chapter 1.2.4 --- Bone Remodeling --- p.7 / Chapter 1.3 --- Low Magnitude High Frequency Vibration (LMHFV) Stimulation --- p.7 / Chapter 1.3.1 --- Mechanical Stimulation --- p.10 / Chapter 1.3.2 --- Effect of LMHFV on Bone --- p.12 / Chapter 1.4 --- Osteoporosis and Osteoporotic Fractures --- p.16 / Chapter 1.4.1 --- Epidemiology of Osteoporotic Fracture --- p.17 / Chapter 1.4.2 --- Pathophysiology --- p.17 / Chapter 1.4.3 --- Osteoporotic Fracture Healing --- p.20 / Chapter 1.5 --- Bisphosphonate --- p.23 / Chapter 1.5.1 --- Background --- p.23 / Chapter 1.5.2 --- Mechanism of Action --- p.24 / Chapter 1.5.3 --- U sage of Bisphosphonate --- p.25 / Chapter 1.5.4 --- Bisphosphonate Effects on Fracture Healing --- p.27 / Chapter 1.6 --- Hypothesis --- p.27 / Chapter 1.7 --- Study Plan --- p.28 / Chapter 1.7.1 --- Objectives --- p.28 / Chapter 2 --- Method --- p.29 / Chapter 2.1 --- Ovariectomized Rat Femoral Fracture Model --- p.29 / Chapter 2.1.1 --- Ovariectomized Rat Model. --- p.29 / Chapter 2.1.2 --- Closed Femoral Fracture --- p.31 / Chapter 2.2 --- Study Design --- p.32 / Chapter 2.3 --- LMHFV Treatment Protocol --- p.32 / Chapter 2.4 --- Bisphosphonate Treatment Protocol --- p.35 / Chapter 2.4.1 --- Pharmacological Parameters --- p.35 / Chapter 2.4.2 --- Ibandronate Injection Solution Preparation --- p.37 / Chapter 2.4.3 --- Injection --- p.37 / Chapter 2.5 --- Fluorochrome Labeling --- p.38 / Chapter 2.5.1 --- Fluorochrome Preparation --- p.38 / Chapter 2.5.2 --- Injection --- p.38 / Chapter 2.6 --- Assessments --- p.39 / Chapter 2.6.1 --- Radiographic Analysis --- p.39 / Chapter 2.6.2 --- uCT Analysis --- p.40 / Chapter 2.6.3 --- Undecalcified Histology --- p.43 / Chapter 2.6.4 --- ELISA Analysis on Bone Markers --- p.47 / Chapter 2.7 --- Statistical Analysis --- p.50 / Chapter 3 --- Results --- p.51 / Chapter 3.1 --- Radiographic Analysis --- p.52 / Chapter 3.1.1 --- Callus Bridging Rate --- p.52 / Chapter 3.1.2 --- Callus Width and Area --- p.52 / Chapter 3.2 --- uCT Analysis --- p.55 / Chapter 3.3 --- Histomorphometric Analysis --- p.61 / Chapter 3.3.1 --- Bone Mineralization Rate --- p.61 / Chapter 3.4 --- Bone Markers Analysis --- p.64 / Chapter 3.4.1 --- Osteocalcin --- p.64 / Chapter 3.4.2 --- TRAP5b --- p.64 / Chapter 3.4.3 --- Summary --- p.67 / Chapter 4 --- Discussion --- p.69 / Chapter 4.1 --- LMHFV Enhanced Bone Remodeling --- p.69 / Chapter 4.1.1 --- LMHFV Reversed Bis Inhibition on Bone Remodeling --- p.70 / Chapter 4.1.2 --- LMHFV Effect on Osteoclastic Resorption During Bone Re-modeling --- p.71 / Chapter 4.2 --- Enhanced Fracture Healing by LMHFV --- p.72 / Chapter 4.2.1 --- Acceleration of Fracture Healing by LMHFV --- p.72 / Chapter 4.2.2 --- LMHFV Inhibits Osteoclast Activity in the Early Phase of Healing --- p.73 / Chapter 4.2.3 --- LMHFV Stimulates Osteoblast Activity in the Early Phase of Healing --- p.74 / Chapter 4.3 --- Bis Delays Fracture Healing --- p.75 / Chapter 4.4 --- Experimental Design --- p.78 / Chapter 4.4.1 --- Inhibition Study --- p.78 / Chapter 4.4.2 --- Bisphosphonate Injection Protocol --- p.79 / Chapter 4.4.3 --- Individual Analysis of Bone Formation and Resorption . --- p.81 / Chapter 4.5 --- Clinical Implications --- p.84 / Chapter 4.5.1 --- LMHFV Enhanced Remodeling --- p.84 / Chapter 4.5.2 --- Bisphosphonate Delayed Remodeling --- p.85 / Chapter 4.6 --- Limitations --- p.85 / Chapter 4.6.1 --- Measurement of Bone Resorption --- p.85 / Chapter 4.6.2 --- Osteoporotic Fracture Model --- p.86 / Chapter 4.6.3 --- Inhibition of Bone Remodeling --- p.87 / Chapter 4.7 --- Future Studies --- p.88 / Chapter 4.7.1 --- LMHFV Effect on Osteoclast in vitro --- p.88 / Chapter 4.7.2 --- Biomechanics of Fracture Callus --- p.89 / Chapter 4.7.3 --- LMHFV Effect on Leptin- Adrenergic Pathway --- p.89 / Chapter 5 --- Conclusion --- p.91 / Bibliography --- p.93

Chung, Shu Lu. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 109-118). / Abstracts in English and Chinese. / Abstract --- p.i-iv / 中文摘要 --- p.v-vii / Publications --- p.viii / Acknowledgements --- p.ix / List of Abbreviations --- p.x-xi / Index for Figures --- p.xii-xiv / Index for Tables --- p.xv / Table of Contents --- p.xvi-xix / Chapter Session 1: --- Introduction --- p.1 / Chapter 1.1 --- Biology of fracture healing process --- p.2 / Chapter 1.1.1 --- Stage of inflammation --- p.2-3 / Chapter 1.1.2 --- Stage of soft callus formation --- p.3-4 / Chapter 1.1.3 --- Stage of hard callus formation --- p.4-5 / Chapter 1.1.4 --- Stage of bone remodeling --- p.5 / Chapter 1.2 --- Conventional treatments and its limitations --- p.5-6 / Chapter 1.3 --- Biological treatments in accelerating fracture healing process --- p.6-7 / Chapter 1.4 --- Biophysical treatments in accelerating fracture healing process --- p.7-8 / Chapter 1.4.1 --- Electromagnetic fields --- p.8-9 / Chapter 1.4.2 --- Shockwave --- p.9 / Chapter 1.4.3 --- Low intensity pulsed ultrasound --- p.9-11 / Chapter 1.5 --- Properties of ultrasound --- p.11 / Chapter 1.5.1 --- Ultrasound signals --- p.11-12 / Chapter 1.5.2 --- Attenuation of ultrasound --- p.12-14 / Chapter 1.5.3 --- Modes of ultrasound wave propagation --- p.14-15 / Chapter 1.5.4 --- Reflection and critical angle --- p.15-18 / Chapter 1.6 --- Insights from previous studies --- p.18-19 / Chapter 1.7 --- Hypothesis --- p.19 / Chapter 1.8 --- Study plan --- p.20 / Chapter 1.9 --- Objectives --- p.20 / Chapter Session 2: --- Materials and Methodology --- p.25 / Chapter 2.1 --- Materials --- p.26 / Chapter 2.2. --- Closed femoral fracture rat model --- p.26 / Chapter 2.2.1 --- Operation procedures --- p.26-27 / Chapter 2.3 --- Groupings --- p.27 / Chapter 2.4 --- Low Iintensity Pulsed Ultrasound treatment --- p.28 / Chapter 2.4.1 --- Incident angles determination --- p.28 / Chapter 2.4.2 --- LIPUS devices --- p.29 / Chapter 2.4.2 --- Set up of standardized platform --- p.29-30 / Chapter 2.4.4 --- Treatment procedure --- p.30 / Chapter 2.5 --- Radiographic analysis --- p.31 / Chapter 2.6 --- Micro-Computed Tomography --- p.32 / Chapter 2.6.1 --- Micro-Computed Tomography scanning --- p.32 / Chapter 2.6.2 --- Micro-Computed Tomography analysis --- p.32-33 / Chapter 2.7 --- Histology --- p.34 / Chapter 2.7.1 --- Sample preparation --- p.34 / Chapter 2.7.2 --- Histomorphometrical analysis --- p.34-35 / Chapter 2.8 --- Mechanical Testing --- p.35 / Chapter 2.9 --- Statistical analysis --- p.35 / Chapter Session 3: --- Results --- p.48 / Chapter 3.1 --- Radiographic analysis --- p.49 / Chapter 3.1.1 --- Qualitative analysis - Callus bridging rate --- p.49 / Chapter 3.1.2 --- Quantitative analysis - Callus area and callus width --- p.49-50 / Chapter 3.2 --- Micro-computed tomography analysis --- p.50 / Chapter 3.2.1 --- Qualitative analysis - 3D reconstructed images --- p.50-51 / Chapter 3.2.2 --- Quantitative analysis - Bone volume of callus --- p.51 / Chapter 3.2.3 --- Quantitative analysis - Bone mineral density and bone mineral content --- p.51-52 / Chapter 3.3 --- Biomechanical test --- p.52-53 / Chapter 3.4 --- Histomorphological analysis --- p.53 / Chapter 3.4.1 --- Qualitative analysis --- p.53 / Chapter 3.4.2 --- Quantitative analysis --- p.53-54 / Chapter Session 4: --- Discussion --- p.85-87 / Chapter 4.1 --- Enhancement effects of LIPUS at different incident angles --- p.88 / Chapter 4.1.1 --- LIPUS transmitted at 350 accelerated the fracture healing process --- p.88 / Chapter 4.1.1.1 --- Callus bridging and callus mineralization --- p.88-89 / Chapter 4.1.1.2 --- Dose dependent effects of LIPUS -Maximization of ultrasound energy --- p.89-90 / Chapter 4.1.2 --- LIPUS transmitted at 35° enhanced the restoration of mechanical properties in fracture healing process --- p.90 / Chapter 4.1.2.1 --- Biomechanical properties --- p.90-91 / Chapter 4.1.2.2 --- Bone mineral density and bone mineral content --- p.91-92 / Chapter 4.1.2.3 --- Highly mineralized callus area and volume --- p.92-93 / Chapter 4.2 --- 35° may be the critical angle for further enhancing fracture healing --- p.93 / Chapter 4.2.1 --- LIPUS transmitted at 35° may be the first critical angle in this study --- p.93-95 / Chapter 4.2.2 --- Effects of different incident angles --- p.95-96 / Chapter 4.3 --- Mechanism of LIPUS at different incident angles on fracture healing process --- p.96 / Chapter 4.3.1 --- Endochondral ossification --- p.96-99 / Chapter 4.4 --- Advantages in using LIPUS transmitted at critical angle --- p.99 / Chapter 4.5 --- Limitations of the study --- p.100 / Chapter 4.5.1 --- Animal model --- p.100 / Chapter 4.5.2 --- Treatment sites of LIPUS transmitted at different incident angles --- p.100 / Chapter 4.5.3 --- Types of fracture --- p.101 / Chapter Session 5: --- Conclusions --- p.102-104 / Chapter Session 6: --- Future Studies --- p.105 / Chapter 6.1 --- Protocol and regime of LIPUS transmitted at different angles --- p.106 / Chapter 6.2 --- Periosteum-stripped fracture model --- p.106-107 / Chapter 6.3 --- Molecular mechanism of LIPUS transmitted at different incident angles --- p.107-108 / Bibliography --- p.109-118 / Appendix I --- p.119

Bibliography: leaves 216-231. / xvii, 231, [99] leaves : / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Examines the sliding capability of external fixators under load and describes the development and testing of an external fixator capable of providing axial cyclic motion to a fracture site while a patient is walking. / Thesis (M.D.)--University of Adelaide, Dept. of Orthopaedics and Trauma, 1999?

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

Bibliography: leaves 216-231. Examines the sliding capability of external fixators under load and describes the development and testing of an external fixator capable of providing axial cyclic motion to a fracture site while a patient is walking.