Altering the course of fracture healing monitoring

Ultrasensitive capacitive sensing system for smart medical devices with ability to monitor fracture healing stages

“…The detection principle of their capacitive sensing system is based on the electric capacitive changes caused by stiffness changes of the bone callus, occurring when the external fixator undergoes mechanical deformations due to external loading. Differently, our technology was designed to monitor the healing process based on capacitive changes due to dielectric changes of bone tissues that occur during the healing process.The approach proposed by Sorriento et al presents higher risks of post-operative complications compared to our monitoring approach: their technology is only intended for applications requiring external fixators, which are highly associated with pin-track infections and poor unions [15]; our technology was designed for incorporation into smart implantable osteosynthesis plate systems, which present lower risks of complications and higher healing rates [15]. If excessive external loads are applied to insufficiently rigid bone–implant callus, plastic deformation of the external fixator may occur and, consequently, surgical reintervention may be required.…”

“…Recent advances have been focused on innovative monitoring methodologies, both invasive and non-invasive, using external fixators, osteosynthesis plates and intramedullary nails. Concerning external fixators, usually implanted in patients with open or infected fractures, the following approaches were already developed [15]: mechanical vibration [16], electrical impedance [17,18] and electromagnetic radiation [19]. Concerning osteosynthesis plates, a treatment option for long bone stabilization (in particular for distal tibial and femoral fractures), in addition to mechanical vibration [20], electric impedance [21][22][23] and electromagnetic radiation [13,24], methodologies based on electric charge [25] and mechanical displacement [26] have also been developed to monitor bone fracture stages [15].…”

“…Concerning external fixators, usually implanted in patients with open or infected fractures, the following approaches were already developed [15]: mechanical vibration [16], electrical impedance [17,18] and electromagnetic radiation [19]. Concerning osteosynthesis plates, a treatment option for long bone stabilization (in particular for distal tibial and femoral fractures), in addition to mechanical vibration [20], electric impedance [21][22][23] and electromagnetic radiation [13,24], methodologies based on electric charge [25] and mechanical displacement [26] have also been developed to monitor bone fracture stages [15]. Intramedullary nails were instrumented with sensing systems along their length to monitor the biomechanical environment of the fractured regions.…”

“…Instrumented fixation systems have already been developed comprising remote detection, processing and communication systems [18]. Significant improvements related to bone–implant callus monitoring were obtained in comparison to conventional imaging methods, including higher resolution and sensitivity [15]. However, developed technologies still have severe limitations: (i) they do not allow multi-region targeted monitoring for three-dimensional detection along the fractured regions; (ii) they are unable to operate without extracorporeal excitations; and (iii) they are not able to provide sufficient specificity in the identification of healing scenarios.…”

“…Intramedullary nails were instrumented with sensing systems along their length to monitor the biomechanical environment of the fractured regions. However, only monitoring methodologies based on mechanical vibration [27] and electromagnetic radiation [28] were developed [15]. Instrumented fixation systems have already been developed comprising remote detection, processing and communication systems [18].…”