I-Corps: Integrated Strain Sensor for Dynamic Hip Screws

I-Corps：用于动态髋螺钉的集成应变传感器

• 批准号: 1933649
• 负责人: John DesJardins
• 金额: $ 5万
• 依托单位: Clemson University
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-06-15 至 2020-12-31
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=1933649&HistoricalAwards=false
• 关键词: Corps; Integrated; Strain; Sensor; Dynamic

The broader impact/commercial potential of this I-Corps project stems from the potential of the technology to address a key clinical gap hip fracture treatment. Intertrochanteric hip fractures are common among elderly patients, affecting their mobility and quality of life. They are routinely treated with a dynamic hip screw (DHS) consisting of a titanium plate and cannulated lag screw that hold the fractured ball of the hip onto the rest of the femur so that the fracture can heal. Like most implants for fracture fixation, the DHS is not designed for long-term load bearing. If a patient's fracture does not heal after surgery, then the DHS or bone will fatigue and fail, requiring revision surgery. This leaves clinicians in a difficult position, as they must carefully monitor their patients for signs of implant failure after surgery. However, by the time signs of failure are apparent, it is often too late to salvage the implant, and a revision surgery is necessary. This device can provide a way to quantitively track fracture healing, enabling physicians and patients to alter rehabilitation protocols and add adjunctive therapies to avoid morbidity and mortality associated with catastrophic implant failure.This I-Corps project focuses on a novel device to help physicians manage hip fracture rehabilitation. The envisioned device is unique in that it can be seamlessly integrated into existing dynamic hip screw (DHS) systems and is read using plain radiography, which is already acquired during follow-up visits but is not quantitative or sensitive enough for tracking fracture stiffness without this sensor. Specifically, the device measures screw bending during weight bearing: immediately after fixation, the screw holds the femur together, carries the full load, and bends significantly under load. However, as the fracture heals and the surrounding bone carries more load, and the screw bends proportionately less. Although the degree of bending is too small to accurately measure from traditional radiographs, this device uses a straight radio-dense tungsten rod through the hollow part of the screw to clearly highlight displacement. Preliminary results have shown proof-of-principle in computer simulations, cadaveric specimens, and a sheep study. Measuring fracture stiffness is important because if the fracture heals too slowly, the implant or bone will fatigue and fail, requiring costly and risky revision surgery.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.

该 I-Corps 项目更广泛的影响/商业潜力源于该技术解决关键临床间隙髋部骨折治疗的潜力。股骨转子间髋部骨折在老年患者中很常见，影响他们的活动能力和生活质量。他们通常使用动态髋螺钉 (DHS) 进行治疗，该螺钉由钛板和空心拉力螺钉组成，将骨折的髋关节球固定在股骨的其余部分上，以便骨折愈合。与大多数骨折固定植入物一样，DHS 并非设计用于长期承载。如果患者的骨折在手术后未愈合，则 DHS 或骨骼会疲劳并失效，需要进行翻修手术。这让临床医生陷入困境，因为他们必须在手术后仔细监测患者是否有植入失败的迹象。然而，当失败迹象明显时，挽救植入物通常为时已晚，需要进行修复手术。该设备可以提供一种定量跟踪骨折愈合的方法，使医生和患者能够改变康复方案并添加辅助治疗，以避免与灾难性植入失败相关的发病率和死亡率。该 I-Corps 项目重点开发一种新型设备，帮助医生管理髋部骨折康复。该设想的设备的独特之处在于，它可以无缝集成到现有的动态髋螺钉 (DHS) 系统中，并使用平片进行读取，平片已在随访期间获得，但在没有该传感器的情况下，其定量或灵敏度不足以跟踪骨折刚度。具体来说，该设备测量承重期间的螺钉弯曲：固定后，螺钉立即将股骨固定在一起，承受全部负载，并在负载下显着弯曲。然而，随着骨折愈合并且周围的骨头承受更多的负载，螺钉的弯曲也会相应减少。尽管弯曲程度太小，无法从传统射线照片中准确测量，但该设备使用一根直的无线电致密钨棒穿过螺钉的中空部分，以清晰地突出位移。初步结果已在计算机模拟、尸体标本和绵羊研究中证明了原理。测量骨折硬度很重要，因为如果骨折愈合太慢，植入物或骨头就会疲劳并失效，需要昂贵且危险的翻修手术。该奖项反映了 NSF 的法定使命，并通过使用基金会的智力优点和更广泛的影响审查标准进行评估，被认为值得支持。