Three-dimensional strain fields in a uniform osteotomy gap.

Stable internal fixation usually results in a unique histological healing pattern which involves direct cortical reconstruction and an absence of periosteal bridging callus. While it has been suggested that longitudinal interfragmentary strain levels control this healing pattern, the complex, multiaxial strain fields in the interfragmentary region are not well understood. Based on an in-vivo study of gap healing in the sheep tibia by Mansmann et al., we used several finite element models of simplified geometry to: explore modeling assumptions on material linearity and deformation kinematics, and examine the strain distribution in a healing fracture gap subjected to known levels of interfragmentary strain. We found that a general nonlinear material, nonlinear geometric analysis is necessary to model an osteotomy gap subjected to a maximum longitudinal strain of 100 percent. The large displacement, large strain conditions which were used in the in-vivo study result in complex, multiaxial strain fields in the gap. Restricting the maximum longitudinal strain to 10 percent allows use of a linear geometric formulation without compromising the numerical results. At this reduced strain level a linear material model can be used to examine the extent of material yielding within a homogeneous osteotomy gap. Severe local strain variations occurred both through the thickness of the gap and radially from the endosteal to periosteal gap surfaces. The bone/gap interface represented a critical plane of high distortional and volumetric change and principal strain magnitudes exceeded the maximum longitudinal strains.