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There are currently no standardized methods for assessing fracture healing, with physicians relying on X-rays which are only useful at later stages of repair. Using in vivo mouse fracture models, we present the first evidence that microscale instrumented implants provide a route for post-operative fracture monitoring, utilizing electrical impedance spectroscopy EIS to track the healing tissue with high sensitivity.
In this study, we fixed mouse long bone fractures with external fixators and bone plates. EIS measurements taken across two microelectrodes within the fracture gap were able to track longitudinal differences between individual mice with good versus poor healing. We additionally present an equivalent circuit model that combines the EIS data to classify fracture repair states. These results demonstrate that EIS can be integrated into current fracture management strategies such as bone plating, providing physicians with quantitative information about the state of fracture repair to guide clinical decision-making for patients.
Musculoskeletal injuries are among the most disabling conditions in the United States, with the total number of bone fractures ranging from 12 to 15 million per year 1. Treatment of these fractures represents a significant burden on the U. Determining how well a fracture is healing is crucial to making correct clinical decisions for patients, but multiple studies cite the lack of standardized methods for assessing fracture union 3 , 4 , 5 , 6. Radiographic imaging and physical evaluation are two common methods of monitoring bone fracture healing in the clinic.
Plain X-ray radiographs are often used, but studies have shown that these correlate poorly with bone strength, do not define union with enough accuracy, and are unreliable for determining the stage of fracture repair 7. Computed tomography CT , dual energy X-ray absorptiometry DEXA , and ultrasound can offer improved diagnostic capabilities, but have limited use in the clinic primarily due to cost and high radiation dose 7 , 8.
