ArticleAnnals of biomedical engineering2026
Bone Formation Between 2.5 and 25% Interfragmentary Strain Induced by Immediate and Delayed Loading in a Bone Healing Model with a Monotonic Strain Gradient.
Article in Annals of biomedical engineering, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Evaluation of continuous axial stress on tibial fracture healing in canine models using custom external fixator.American journal of translational research · 2026Article
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Authors and funding
9 authors.
Funding
Abstract
purposeThis study investigated the formation of fracture repair tissue in response to 2.5-25% strain magnitudes under immediate and delayed loading in a large animal model with monotonically increasing interfragmentary strain.
methodsExperimental osteotomies were created in ten sheep and were instrumented with an active fixator that generated a gradient (2.5-25%) of interfragmentary strain across the osteotomy. Sheep were randomly assigned to an immediate-loading (from day 1 post-surgery) group or a delayed-loading (from day 22 post-surgery) group. Five weeks post-surgery, the tibiae were scanned using high-resolution computed tomography (CT). CT images were subsequently sliced at different strain levels. For each two-dimensional slice, we evaluated the area and density of fracture repair tissue within the osteotomy and the radial span of the periosteal tissue. Repeated-measures ANOVA tested the effects of strain magnitude and loading protocol on these parameters.
resultsThe area and density of osteotomy repair tissue were highest at 2.5% of strain for both groups and significantly decreased when strain increased (p ≤ 0.015). In contrast, periosteal tissue span increased with strain (p < 0.001) and was significantly larger in the immediate-loading group (p < 0.01).
conclusionOur study demonstrates the combined effect of strain (2.5-25%) and the timing of loading on bone healing. We observed two strain-related healing responses: up to ~ 7.5% strain, callus formed between the cortices, while higher strain shifted calcified repair tissue toward external callus. In this experimental model, strains below 25% provided a potent healing environment when stimulation was applied during the early healing stage.
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