The simulation of tissue differentiation at a fracture gap using a mechano-regulation theory dealing with deviatoric strains in the presence of a composite bone plate

The endochondral ossification process of fractured long bones was simulated using a three-dimensional finite element model when various composite bone plates were applied to the fracture site. To simulate time-varying cell phenotypes and the corresponding deviatoric strains in the calluses, a user’s subroutine was programmed for iterative calculations. Three representative initial loading conditions were investigated to find a relationship between the initial loading condition and tissue differentiation. Through finite element analysis, the trends in tissue differentiation and healing efficiency in the calluses were evaluated according to the plate modulus and loading conditions; further, the most appropriate plate modulus under each initial loading condition was suggested.