Microhardness distribution of the fibula diaphysis in human skeleton
Wang Jiangzhao1, Liu Guobin1, Zhang Xiaojuan1, Li Sheng1, Yin Bing1, Hu Zusheng1, Wu Weiwei1, Liu Yake2, Zhang Yingze1
1Department of Orthopedic Surgery, the Third Hospital of Hebei Medical University, Orthopaedic Research Institution of Hebei Province, Key Laboratory of Orthopaedic Biomechanics of Hebei Province, Shijiazhuang 050051, China; 2Department of Orthopedics, the Affiliated Hospital of Nantong University, Nantong 226001, China
Abstract：Objective To explore the distribution characteristics of bone tissue microhardness in fibula diaphysis.Methods Three fresh right fibulae were obtained from 3 cadaver donors (male, 62 years old; female, 45 years old; male, 58 years old, all without previous chronic medical history). Each of the fibula diaphysis was divided into six parts, bone specimens with a thickness of 3mm were taken from the middle of each part by using a high-precision low-speed diamond saw. Each specimen was divided into four regions to measure the bone tissue microhardness. Five effective indentations were performed in each region to obtain microhardness values with the Vickers methord. The microhardness distribution characteristics of different parts and regions in each part were analyzed. The differences in bone tissue microhardness of different parts and regions were compared.Results A total of 18 bone specimens were obtained in this study. Three hundred and sixty effective indentation tests were performed in 72 regions and the microhardness values were obtained. The mean microhardness of the anterior, medial, posterior and lateral cortex of the 3 fibulae diaphysis were (46.81±4.51) HV, (49.69±4.05) HV, (51.19±4.19) HV and (50.44±4.10) HV, respectively. The microhardness of the anterior cortex was the lowest, and that of the posterior cortex was the highest; the differences among the different regions were statistically significant (F=18.590, P＜0.01). The mean microhardness of the 6 parts of the fibula diaphysis was (48.63±4.88) HV, (49.66±4.19) HV, (49.50±4.67) HV, (51.07±4.08) HV, (49.96±4.24) HV and (48.39±4.63) HV, respectively. The microhardness of part 4 of the fibula diaphysis was the highest and the microhardness of part 6 was the lowest. There was no significant difference in microhardness between different layers in the same area (all P values＞0.05). Within the same part, the difference of microhardness among different regions at the part 1-4 was statistically significant (all P values＜0.05), while the difference of microhardness between different regions at the 5 and 6 layers was not statistically significant (all P values＞0.05).Conclusions This study reports that the microhardness of bone tissue in different regions and different parts of the fibula diaphysis are difference. Understanding the difference in microhardness between different regions and parts is important. Because it is helpful for orthopedic surgeons to select the appropriate direction in the autologous fibula grafting, to reduce the occurrence of graft fatigue failure. The results can also provide data support for the manufacture of 3D printed bionic bone with higher precision.
王建朝, 刘国彬, 张晓娟, 李升, 殷兵, 胡祖圣, 吴卫卫, 刘雅克, 张英泽. 人体腓骨体部骨组织显微硬度的分布特征[J]. 中华解剖与临床杂志, 2019, 24(5): 430-434.
Wang Jiangzhao, Liu Guobin, Zhang Xiaojuan, Li Sheng, Yin Bing, Hu Zusheng, Wu Weiwei, Liu Yake, Zhang Yingze. Microhardness distribution of the fibula diaphysis in human skeleton. Chinese Journal of Anatomy and Clinics, 2019, 24(5): 430-434.
Mitchell JJ, Bailey JR, Bozzio AE, et al. Fixation of distal fibula fractures: an update[J]. Foot Ankle Int, 2014, 35(12): 1367-1375. DOI:10.1177/1071100714555712.
[2]
Logan H, Wolfaardt J, Boulanger P, et al. Exploratory benchtop study evaluating the use of surgical design and simulation in fibula free flap mandibular reconstruction[J]. J Otolaryngol Head Neck Surg, 2013, 42: 42. DOI:10.1186/1916-0216-42-42.
[3]
Malizos KN, Zalavras CG, Soucacos PN, et al. Free vascularized fibular grafts for reconstruction of skeletal defects[J]. J Am Acad Orthop Surg, 2004, 12(5): 360-369.
[4]
Ide Y, Matsunaga S, Harris J, et al. Anatomical examination of the fibula: digital imaging study for osseointegrated implant installation[J]. J Otolaryngol Head Neck Surg, 2015, 44: 1. DOI:10.1186/s40463-015-0055-9.
[5]
Seikaly H, Chau J, Li F, et al. Bone that best matches the properties of the mandible[J]. J Otolaryngol, 2003, 32(4): 262-265.
[6]
Ohman C, Zwierzak I, Baleani M, et al. Human bone hardness seems to depend on tissue type but not on anatomical site in the long bones of an old subject[J]. Proc Inst Mech Eng H, 2013, 227(2): 200-206. DOI:10.1177/0954411912459424.
[7]
Currey JD, Brear K. Hardness, Young's modulus and yield stress in mammalian mineralized tissues[J]. J Mater Sci Mater Med, 1990, 1(1): 14-20. DOI:10.1007/bf00705348.
ASTM E384-17 A. Standard test method for microindentation hardness of materials[S]. West Conshohecken: American Society for Testing of Materials (ASTM), 2017. DOI:10.1520/e0384-17.
[10]
Dall'Ara E, Schmidt R, Zysset P. Microindentation can discriminate between damaged and intact human bone tissue[J]. Bone, 2012, 50(4): 925-929. DOI:10.1016/j.bone.2012.01.002.
[11]
Johnson WM, Rapoff AJ. Microindentation in bone: hardness variation with five independent variables[J]. J Mater Sci Mater Med, 2007, 18(4): 591-597. DOI:10.1007/s10856-007-2306-4.
[12]
Tommasini SM, Nasser P, Hu B, et al. Biological co-adaptation of morphological and composition traits contributes to mechanical functionality and skeletal fragility[J]. J Bone Miner Res, 2008, 23(2): 236-246. DOI:10.1359/jbmr.071014.
[13]
Boivin G, Bala Y, Doublier A, et al. The role of mineralization and organic matrix in the microhardness of bone tissue from controls and osteoporotic patients[J]. Bone, 2008, 43(3): 532-538. DOI:10.1016/j.bone.2008.05.024.
[14]
Cristofolini L, Conti G, Juszczyk M, et al. Structural behaviour and strain distribution of the long bones of the human lower limbs[J]. J Biomech, 2010, 43(5): 826-835. DOI:10.1016/j.jbiomech.2009.11.022.
[15]
Marchi D, Shaw CN. Variation in fibular robusticity reflects variation in mobility patterns[J]. J Hum Evol, 2011, 61(5): 609-616. DOI:10.1016/j.jhevol.2011.08.005.
[16]
Cointry GR, Nocciolino L, Ireland A, et al. Structural differences in cortical shell properties between upper and lower human fibula as described by pQCT serial scans. A biomechanical interpretation[J]. Bone, 2016, 90: 185-194. DOI:10.1016/j.bone.2016.06.007.
[17]
Rantalainen T, Nikander R, Heinonen A, et al. Direction-specific diaphyseal geometry and mineral mass distribution of tibia and fibula: a pQCT study of female athletes representing different exercise loading types[J]. Calcif Tissue Int, 2010, 86(6): 447-454. DOI:10.1007/s00223-010-9358-z.
[18]
Yang PF, Sanno M, Ganse B, et al. Torsion and antero-posterior bending in the in vivo human tibia loading regimes during walking and running[J]. PLoS One, 2014, 9(4): e94525. DOI:10.1371/journal.pone.0094525.
[19]
Wang J, Yin B, Liu G, et al. Microhardness distribution of the tibial diaphysis and test site selection for reference point indentation technique[J]. Medicine (Baltimore), 2019, 98(29): e16523. DOI:10.1097/MD.0000000000016523.
[20]
Ruff C, Holt B, Trinkaus E. Who's afraid of the big bad Wolff?: “Wolff's law” and bone functional adaptation[J]. Am J Phys Anthropol, 2006, 129(4): 484-498. DOI:10.1002/ajpa.20371.
Chou SW, Liao HT, Yazar S, et al. Assessment of fibula osteoseptocutaneous flap donor-site morbidity using balance and gait test[J]. J Orthop Res, 2009, 27(4): 555-560. DOI:10.1002/jor.20687.
[23]
Lin JY, Djohan R, Dobryansky M, et al. Assessment of donor-site morbidity using balance and gait tests after bilateral fibula osteoseptocutaneous free flap transfer[J]. Ann Plast Surg, 2009, 62(3): 246-251. DOI:10.1097/SAP.0b013e31817e9d1a.
[24]
Ling XF, Peng X. What is the price to pay for a free fibula flap? A systematic review of donor-site morbidity following free fibula flap surgery[J]. Plast Reconstr Surg, 2012, 129(3): 657-674. DOI:10.1097/prs.0b013e3182402d9a.
[25]
Dror Paley F. Principles of deformity correction[M]. Springer, 2014: 2.
[26]
Brydone AS, Meek D, MacLaine S. Bone grafting, orthopaedic biomaterials, and the clinical need for bone engineering[J]. Proc Inst Mech Eng H, 2010, 224(12): 1329-1343. DOI:10.1243/09544119jeim770.
2019, Vol. 24 
