{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T12:43:57Z","timestamp":1787921037525,"version":"build-2784847793"},"reference-count":29,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T00:00:00Z","timestamp":1725235200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100019014","name":"Chengdu Municipal Science and Technology Program","doi-asserted-by":"publisher","award":["00402053A29BH"],"award-info":[{"award-number":["00402053A29BH"]}],"id":[{"id":"10.13039\/501100019014","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Although the specific relationship between the stress changes in the external fixator during tibial fracture treatment and the bone healing process remains unclear, it is believed that stress variations in the external fixator scaffold can, to a certain extent, reflect the progress of tibial healing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aims to propose a non\u2010invasive method for assessing the degree of fracture healing by monitoring the changes in stress transmission, the locations of stress\u2010sensitive points, and displacement in the external fixator\u2010tibia system during the healing process of tibial fractures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this study, finite element models of tibial fractures at various healing stages were developed. Physiological conditions, including axial, torsional, and bending loads on the tibia, were simulated to evaluate stress and strain within the external scaffold\u2010tibia system under normal physiological loading conditions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The results indicate variations in the stress distribution between the external fixator and the tibia during different stages of healing. In the early phase of fracture healing, the external fixator plays a crucial role as the primary load\u2010bearing unit under all three loading conditions. As the fracture healing progresses, the stress on the tibia gradually increases, concentrating on the medial part of the tibia under axial and torsional loading, and at the upper and lower ends, as well as the central part of the anterior and posterior tibia during bending loading. The stress at the callus gradually increases, while micro\u2010movements decrease. The stress within the external bracket gradually decreases, with a tendency for the connecting rod to transfer stress towards the screws. Throughout the fracture healing process, the location of maximum stress in the external fixator remains unchanged. Under axial and torsional loading, the maximum stress is located at the intersection of the lowest screw and the bone cortex, while under bending loading, it is at the intersection of the second screw and the connecting rod.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>During the bone healing process, stress is transferred between the external fixation frame and the bone. As bone healing advances, the stress on the connecting rods and screws of the external fixation frame decreases, and the amplitude of stress changes diminishes. When complete and robust fusion is achieved, stress variations stabilize, and the location of maximum stress on the external fixation frame remains unchanged. The intersections of the lowest screw and the bone cortex, as well as the second screw and the connecting rod, can serve as sensitive points for monitoring the degree of bone healing.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.14195","type":"journal-article","created":{"date-parts":[[2024,9,3]],"date-time":"2024-09-03T03:25:56Z","timestamp":1725333956000},"page":"2821-2833","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["How Does the Stress in the Fixation Device Change during Different Stages of Bone Healing in the Treatment of Fractures? A Finite Element Study of External Fixation for Tibial Fractures"],"prefix":"10.1111","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0341-196X","authenticated-orcid":false,"given":"Xuehai","family":"Jia","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Orthopedic Research Institute, West China Hospital Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changyong","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Orthopedic Research Institute, West China Hospital Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Ya'an People's Hospital  Ya\u2019an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Orthopedic Research Institute, West China Hospital Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Orthopedic Research Institute, West China Hospital Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Orthopedic Research Institute, West China Hospital Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Computer Science and Technology Southwest University of Science and Technology  Mianyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Litai","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Orthopedic Research Institute, West China Hospital Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1302\/2058-5241.3.170072"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.12538"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-021-05073-7"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2017.11.009"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000137550.68318.f8"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-023-04472-3"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-020-03930-x"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.M.00385"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1109\/TUFFC.2008.787"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000000207"},{"key":"e_1_2_10_12_1","first-page":"190","volume-title":"Clinical orthopaedics and related research (1976\u20132007)","author":"Cattermole HC","year":"1997"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijnm.IJNM_50_17"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1109\/ANTEM.2018.8572872"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-002-0306-x"},{"key":"e_1_2_10_16_1","unstructured":"ChatterjeeS ChatterjeeS.(1AD) Finite Element Analysis in Biomechanics. 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