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Staubli has studied the mode of bone healing in opening wedge osteotomy and found that gap filling occurs from apex to base on sequential X rays, presumably influenced by the differing strain environments [31].
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We ask whether this provides an appropriate strain environment for fracture union.
This creates a strain environment favourable for bone formation at the osteotomy site [30].
Accordingly, the microscopic strain environment within a CG scaffold is offered here.
At the apex of the opening wedge, the fracture gap is small and hence has a higher strain environment.
The manner of fracture or osteotomy stabilisation will influence the strain environment and subsequently the way bone is formed in the gap.
One theory is the strain environment is too low at the base, directly under the plate, to stimulate any bone healing, as the fracture gap is too large.
Reducing the background level of the naturally engendered strain environment allows adaptive responses to artificial loading to be demonstrated at lower loads.
Due to their elasticity, titanium nails are thought to promote callus formation by limiting stress shielding [30, 31, 32] and allow for enough movement to generate an optimum bone forming strain environment.
It is questionable as to whether the strain environment provided by the use of a long revision stem bypassing the fracture site alone is adequate even those of 220 mm.
To assist in the design and management of industrial food quality systems, predictive microbiological models have to incorporate major risk factors such as the variability in the microbial strain, environment and initial contamination levels.
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