Bone fracture healing under external fixator: Investigating impacts of several design parameters using Taguchi and ANOVA

In this paper we aim to improve the understanding of the relationship between unilateral-uniplanar external fixator design parameters and their influences on fixator performance. Stability and strength of bone-fixator construct as well as the quality of healing were defined as our major concerns in order to evaluate the performance of fixator. The roles of six key design parameters were assessed during the early stage of healing by using finite element models. Tissue differentiation within the callus was predicted through the implementation of a mechanoregulation theory of bone healing. Taguchi and ANOVA methods were used to achieve optimal design sets for outputs and to determine contribution percentage of each design parameter on outputs. For improving overall fixator performance, optimal set of design parameters consisting of 2 mm, 8 mm, 120 mm, 20 GPa, 50 mm and 20 mm were determined by Taguchi for pin diameter, rod diameter, rod elevation, fixator Young's modulus, distance of the nearest pin to fracture site and distance between adjacent pins, respectively. Also, results of ANOVA revealed that rod elevation is the most important design parameter, with 43 % effectiveness on overall fixator performance, which was followed by fixator material and pin diameter with 28 % and 19 %, respectively. Results of this study can assist orthopedic surgeons to achieve an optimal fixator device with respect to the patient's condition and give insight into the importance of different design parameters.