right what I’m going to talk to you today basically is I’m going to try and
today basically is I’m going to try and
today basically is I’m going to try and get over to you passion for engineering
get over to you passion for engineering
get over to you passion for engineering obviously but I’m also going to try and
obviously but I’m also going to try and
obviously but I’m also going to try and put across to you my passion for bone
put across to you my passion for bone
put across to you my passion for bone because bone is a fantastic material if
because bone is a fantastic material if
because bone is a fantastic material if we could just do this much for a
we could just do this much for a
we could just do this much for a material that was like bone it would be
material that was like bone it would be
material that was like bone it would be absolutely amazing now all this work I’m
absolutely amazing now all this work I’m
absolutely amazing now all this work I’m going to be talking about is actually
going to be talking about is actually
going to be talking about is actually done here in this lovely city of ours
done here in this lovely city of ours
done here in this lovely city of ours stoke-on-trent and more importantly with
stoke-on-trent and more importantly with
stoke-on-trent and more importantly with my good friend prof pete thomas an
my good friend prof pete thomas an
my good friend prof pete thomas an orthopedic surgeon based at Stoke isn’t
orthopedic surgeon based at Stoke isn’t
orthopedic surgeon based at Stoke isn’t he lovely there is one of our babies now
he lovely there is one of our babies now
he lovely there is one of our babies now how did someone who is yes I’m not
how did someone who is yes I’m not
how did someone who is yes I’m not scared to say this bullied at school
scared to say this bullied at school
scared to say this bullied at school just for having a foreign sounding name
just for having a foreign sounding name
just for having a foreign sounding name used to race lawnmowers used to do
used to race lawnmowers used to do
used to race lawnmowers used to do amazing equations and computational
amazing equations and computational
amazing equations and computational methods for designing power stations to
methods for designing power stations to
methods for designing power stations to make sure they don’t shake themselves to
make sure they don’t shake themselves to
make sure they don’t shake themselves to bits get to become a professor in
bits get to become a professor in
bits get to become a professor in medical engineering and find out well
medical engineering and find out well
medical engineering and find out well first of all its absolute chance this is
first of all its absolute chance this is
first of all its absolute chance this is my door I was on summer duties one year
my door I was on summer duties one year
my door I was on summer duties one year and a phone was ringing in an office now
and a phone was ringing in an office now
and a phone was ringing in an office now summer duties basically means clearing
summer duties basically means clearing
summer duties basically means clearing so there could be student so I answered
so there could be student so I answered
so there could be student so I answered the phone wasn’t a student on the end
the phone wasn’t a student on the end
the phone wasn’t a student on the end there was someone talking to me in a
there was someone talking to me in a
there was someone talking to me in a language it sounded absolutely what I
language it sounded absolutely what I
language it sounded absolutely what I understood and I thought I can help this
understood and I thought I can help this
understood and I thought I can help this girl out and but actually you nothing
girl out and but actually you nothing
girl out and but actually you nothing about broken bones orthopaedic but one
about broken bones orthopaedic but one
about broken bones orthopaedic but one thing I did know is that bones break
thing I did know is that bones break
thing I did know is that bones break they do and they break every day the
they do and they break every day the
they do and they break every day the bone we’re going to be talking about is
bone we’re going to be talking about is
bone we’re going to be talking about is the tibia my lovely assistant is
the tibia my lovely assistant is
the tibia my lovely assistant is demonstrating you would call it the shin
demonstrating you would call it the shin
demonstrating you would call it the shin and there’s what I prepared earlier as
and there’s what I prepared earlier as
and there’s what I prepared earlier as you can tell it’s broken but I can hear
you can tell it’s broken but I can hear
you can tell it’s broken but I can hear you now there you’re an engineer what do
you now there you’re an engineer what do
you now there you’re an engineer what do you know about orthopedics well my
you know about orthopedics well my
you know about orthopedics well my philosophy for engineering and
philosophy for engineering and
philosophy for engineering and particularly engineering design is very
particularly engineering design is very
particularly engineering design is very simple I have to know absolutely
simple I have to know absolutely
simple I have to know absolutely everything about the area in which i’m
everything about the area in which i’m
everything about the area in which i’m designing to produce a design that works
designing to produce a design that works
designing to produce a design that works if I don’t then I’m afraid good there’s
if I don’t then I’m afraid good there’s
if I don’t then I’m afraid good there’s no excuses you need to know it so I’ll
no excuses you need to know it so I’ll
no excuses you need to know it so I’ll spread the last 25 years learning
spread the last 25 years learning
spread the last 25 years learning orthopedics now you might be surprised
orthopedics now you might be surprised
orthopedics now you might be surprised to know that actually there’s 430 people
to know that actually there’s 430 people
to know that actually there’s 430 people per million
per million
per million head of population per year across the
head of population per year across the
head of population per year across the world who will need an operation to mend
world who will need an operation to mend
world who will need an operation to mend a broken tibia and that’s that’s just
a broken tibia and that’s that’s just
a broken tibia and that’s that’s just the fact the highest at risk are
the fact the highest at risk are
the fact the highest at risk are basically young adult males probably
basically young adult males probably
basically young adult males probably playing football probably riding a
playing football probably riding a
playing football probably riding a motorbike are doing something just as
motorbike are doing something just as
motorbike are doing something just as stupid unfortunately though if you’re
stupid unfortunately though if you’re
stupid unfortunately though if you’re young and you’re female doesn’t mean
young and you’re female doesn’t mean
young and you’re female doesn’t mean you’re immune you can still break a leg
you’re immune you can still break a leg
you’re immune you can still break a leg but luckily for you bones have evolved
but luckily for you bones have evolved
but luckily for you bones have evolved over millions of years to heal they do
over millions of years to heal they do
over millions of years to heal they do it really really really well my job is
it really really really well my job is
it really really really well my job is to design something that helps the bone
to design something that helps the bone
to design something that helps the bone heal not gets in the way the long bone
heal not gets in the way the long bone
heal not gets in the way the long bone we’re talking about tibia is a long bone
we’re talking about tibia is a long bone
we’re talking about tibia is a long bone it hills by calles calles is another
it hills by calles calles is another
it hills by calles calles is another wonderful think it’s nature’s glue think
wonderful think it’s nature’s glue think
wonderful think it’s nature’s glue think of like a hot glue gun if you can
of like a hot glue gun if you can
of like a hot glue gun if you can imagine a hot glue gun in your head over
imagine a hot glue gun in your head over
imagine a hot glue gun in your head over the next bit you understand what I’m one
the next bit you understand what I’m one
the next bit you understand what I’m one about the thing probably that you won’t
about the thing probably that you won’t
about the thing probably that you won’t think about is that actually it’s got to
think about is that actually it’s got to
think about is that actually it’s got to have movement well movement means this
have movement well movement means this
have movement well movement means this the ends move together and it releases
the ends move together and it releases
the ends move together and it releases callous and that callous builds up and
callous and that callous builds up and
callous and that callous builds up and builds up until it actually comes to
builds up until it actually comes to
builds up until it actually comes to halt that’s when the bone is stiff
halt that’s when the bone is stiff
halt that’s when the bone is stiff enough that’s what it’s healed and
enough that’s what it’s healed and
enough that’s what it’s healed and there’s one we’ve prepared earlier
there’s one we’ve prepared earlier
there’s one we’ve prepared earlier notice the lump now on average it takes
notice the lump now on average it takes
notice the lump now on average it takes about 18 weeks for activity to heal can
about 18 weeks for activity to heal can
about 18 weeks for activity to heal can be as long as 24 can be as short as
be as long as 24 can be as short as
be as long as 24 can be as short as eight and a half weeks but what I do can
eight and a half weeks but what I do can
eight and a half weeks but what I do can tell you is if you smoke your delay it
tell you is if you smoke your delay it
tell you is if you smoke your delay it by at least four weeks and you can stop
by at least four weeks and you can stop
by at least four weeks and you can stop it all together there’s the cameraman he
it all together there’s the cameraman he
it all together there’s the cameraman he smokes that’s his reason to stop now
smokes that’s his reason to stop now
smokes that’s his reason to stop now what about that lump where your body
what about that lump where your body
what about that lump where your body remodels itself continuously over your
remodels itself continuously over your
remodels itself continuously over your whole life and the way it works is that
whole life and the way it works is that
whole life and the way it works is that you have these little cells called
you have these little cells called
you have these little cells called osteoclasts their natures diggers they
osteoclasts their natures diggers they
osteoclasts their natures diggers they go around looking for bits of bone that
go around looking for bits of bone that
go around looking for bits of bone that aren’t needed and they get rid of it
aren’t needed and they get rid of it
aren’t needed and they get rid of it osteoblasts are the opposite they lay
osteoblasts are the opposite they lay
osteoblasts are the opposite they lay down bone just like a builder where it’s
down bone just like a builder where it’s
down bone just like a builder where it’s needed it all works under something
needed it all works under something
needed it all works under something which is called Moore’s Law and it’s
which is called Moore’s Law and it’s
which is called Moore’s Law and it’s very simple where a bone is too big
very simple where a bone is too big
very simple where a bone is too big osteoclasts get rid of the bone and ship
osteoclasts get rid of the bone and ship
osteoclasts get rid of the bone and ship it off somewhere else where a bone is
it off somewhere else where a bone is
it off somewhere else where a bone is too small it lays it down and we end up
too small it lays it down and we end up
too small it lays it down and we end up with an optimum solution if you’ve got a
with an optimum solution if you’ve got a
with an optimum solution if you’ve got a small load you’ll have a small bone if
small load you’ll have a small bone if
small load you’ll have a small bone if you’ve got a big load you’ll have a big
you’ve got a big load you’ll have a big
you’ve got a big load you’ll have a big boat
boat
boat this is one of the reasons why
this is one of the reasons why
this is one of the reasons why astronauts have to exercise in space
astronauts have to exercise in space
astronauts have to exercise in space because in space not only does no one
because in space not only does no one
because in space not only does no one hear you scream but also there’s no
hear you scream but also there’s no
hear you scream but also there’s no gravity and because there’s no gravity
gravity and because there’s no gravity
gravity and because there’s no gravity there’s no load on the bones of those
there’s no load on the bones of those
there’s no load on the bones of those osteocytes thinks it’s party time at the
osteocytes thinks it’s party time at the
osteocytes thinks it’s party time at the buffet so if they don’t exercise when
buffet so if they don’t exercise when
buffet so if they don’t exercise when they come back won’t be a pretty sight
they come back won’t be a pretty sight
they come back won’t be a pretty sight let’s get back to mending tibias if
let’s get back to mending tibias if
let’s get back to mending tibias if you’re unlucky enough to go to hospital
you’re unlucky enough to go to hospital
you’re unlucky enough to go to hospital with a broken leg the first thing is
with a broken leg the first thing is
with a broken leg the first thing is they’ll say is it a stable or an
they’ll say is it a stable or an
they’ll say is it a stable or an unstable fracture a stable fracture is
unstable fracture a stable fracture is
unstable fracture a stable fracture is basically one where if you load the ends
basically one where if you load the ends
basically one where if you load the ends the ends come together and nothing very
the ends come together and nothing very
the ends come together and nothing very much happens an unstable fracture has
much happens an unstable fracture has
much happens an unstable fracture has got a more complex shape and if you load
got a more complex shape and if you load
got a more complex shape and if you load it and the ends come together ping off
it and the ends come together ping off
it and the ends come together ping off it goes in a different direction at one
it goes in a different direction at one
it goes in a different direction at one leg ends up shorter than the other
leg ends up shorter than the other
leg ends up shorter than the other there’s that example again stable
there’s that example again stable
there’s that example again stable fractures you’ll seeing them in plastic
fractures you’ll seeing them in plastic
fractures you’ll seeing them in plastic a stool over the place unstable
a stool over the place unstable
a stool over the place unstable fractures need a bit more support they
fractures need a bit more support they
fractures need a bit more support they need metal work and those an example
need metal work and those an example
need metal work and those an example it’s an external fixator it’s called
it’s an external fixator it’s called
it’s an external fixator it’s called external because it’s outside the body
external because it’s outside the body
external because it’s outside the body and fix means it’s mending it the bit I
and fix means it’s mending it the bit I
and fix means it’s mending it the bit I want you to look at is the bit in the
want you to look at is the bit in the
want you to look at is the bit in the middle because that’s before we started
middle because that’s before we started
middle because that’s before we started our work and we’re going to see that
our work and we’re going to see that
our work and we’re going to see that again in a moment it’s got to come off
again in a moment it’s got to come off
again in a moment it’s got to come off and the way most surgeons will do it is
and the way most surgeons will do it is
and the way most surgeons will do it is they look at your x-rays they look at
they look at your x-rays they look at
they look at your x-rays they look at they look at manipulating the fracture
they look at manipulating the fracture
they look at manipulating the fracture unfortunately those are those methods
unfortunately those are those methods
unfortunately those are those methods are pretty inaccurate which means that
are pretty inaccurate which means that
are pretty inaccurate which means that the most common occurrence is someone
the most common occurrence is someone
the most common occurrence is someone says come back in a few weeks you might
says come back in a few weeks you might
says come back in a few weeks you might be ready then which to an engineer is
be ready then which to an engineer is
be ready then which to an engineer is like a red rag to a bull it’s a bit like
like a red rag to a bull it’s a bit like
like a red rag to a bull it’s a bit like saying I’ll turn on that nuclear power
saying I’ll turn on that nuclear power
saying I’ll turn on that nuclear power station it hasn’t blown up by next week
station it hasn’t blown up by next week
station it hasn’t blown up by next week it’s okay it’s going to work now I want
it’s okay it’s going to work now I want
it’s okay it’s going to work now I want numbers so there was obviously room for
numbers so there was obviously room for
numbers so there was obviously room for improvement now Peter and I soon
improvement now Peter and I soon
improvement now Peter and I soon realized actually those fixators
realized actually those fixators
realized actually those fixators performed two jobs and not very well so
performed two jobs and not very well so
performed two jobs and not very well so let’s divide them into two the first job
let’s divide them into two the first job
let’s divide them into two the first job is reduction that’s basically bringing
is reduction that’s basically bringing
is reduction that’s basically bringing the bones back into alignment now you’re
the bones back into alignment now you’re
the bones back into alignment now you’re probably imagining something really
probably imagining something really
probably imagining something really sophisticated I did know it’s actually a
sophisticated I did know it’s actually a
sophisticated I did know it’s actually a very large assistant pulling on
very large assistant pulling on
very large assistant pulling on someone’s leg for about an hour and I’m
someone’s leg for about an hour and I’m
someone’s leg for about an hour and I’m not joking so there was clearly
not joking so there was clearly
not joking so there was clearly something there there it is there’s our
something there there it is there’s our
something there there it is there’s our mechanical assistance we call it storm
mechanical assistance we call it storm
mechanical assistance we call it storm because it’s this Stafford shear notice
because it’s this Stafford shear notice
because it’s this Stafford shear notice where it’s been designed orthopedic
where it’s been designed orthopedic
where it’s been designed orthopedic reduction machine
reduction machine
reduction machine now what’s it done before and after it’s
now what’s it done before and after it’s
now what’s it done before and after it’s not too difficult to see what change
not too difficult to see what change
not too difficult to see what change we’ve made because the one that was done
we’ve made because the one that was done
we’ve made because the one that was done with storm you can’t even see the
with storm you can’t even see the
with storm you can’t even see the fracture site the other thing is is that
fracture site the other thing is is that
fracture site the other thing is is that the fixator doesn’t need any joints
the fixator doesn’t need any joints
the fixator doesn’t need any joints anymore because all in the other part
anymore because all in the other part
anymore because all in the other part we’re not the only ones you like it
we’re not the only ones you like it
we’re not the only ones you like it other people do then he trouble is I
other people do then he trouble is I
other people do then he trouble is I think we must had too much to drink
think we must had too much to drink
think we must had too much to drink because we just cannot remember what we
because we just cannot remember what we
because we just cannot remember what we were laughing at now the second job they
were laughing at now the second job they
were laughing at now the second job they have to do is it’s in the title it’s
have to do is it’s in the title it’s
have to do is it’s in the title it’s fixed that’s how a little baby but it
fixed that’s how a little baby but it
fixed that’s how a little baby but it hides a lot of complex stuff inside
hides a lot of complex stuff inside
hides a lot of complex stuff inside there there’s an optimum environment for
there there’s an optimum environment for
there there’s an optimum environment for callus formation not only that the
callus formation not only that the
callus formation not only that the callus is formed by people walking
callus is formed by people walking
callus is formed by people walking notice that they’ve got normal shoes on
notice that they’ve got normal shoes on
notice that they’ve got normal shoes on a normal trousers in fact most patients
a normal trousers in fact most patients
a normal trousers in fact most patients walk the next day after operation the
walk the next day after operation the
walk the next day after operation the way it happens basically comes from if
way it happens basically comes from if
way it happens basically comes from if you draw a graph of strength to weight
you draw a graph of strength to weight
you draw a graph of strength to weight ratio anything that’s got a high
ratio anything that’s got a high
ratio anything that’s got a high strength to weight ratio there’s too
strength to weight ratio there’s too
strength to weight ratio there’s too much material will be up above spiders
much material will be up above spiders
much material will be up above spiders webs are really good they’re down the
webs are really good they’re down the
webs are really good they’re down the bottom that’s where the iOS would be not
bottom that’s where the iOS would be not
bottom that’s where the iOS would be not piece of material is wasted same thing
piece of material is wasted same thing
piece of material is wasted same thing goes if the patient’s going to wear it
goes if the patient’s going to wear it
goes if the patient’s going to wear it you need to be functional scorpions
you need to be functional scorpions
you need to be functional scorpions brilliant adapted not very pretty as far
brilliant adapted not very pretty as far
brilliant adapted not very pretty as far as I’m concerned spectacles however
as I’m concerned spectacles however
as I’m concerned spectacles however everyone has got to wear them you pick
everyone has got to wear them you pick
everyone has got to wear them you pick them patients like iOS that’s still got
them patients like iOS that’s still got
them patients like iOS that’s still got to come off we used to use really
to come off we used to use really
to come off we used to use really difficult equipment to measure the
difficult equipment to measure the
difficult equipment to measure the stiffness of the fracture accurately but
stiffness of the fracture accurately but
stiffness of the fracture accurately but it was very time-consuming and
it was very time-consuming and
it was very time-consuming and cumbersome so we built it into our
cumbersome so we built it into our
cumbersome so we built it into our office itself if those pins don’t touch
office itself if those pins don’t touch
office itself if those pins don’t touch the side when he manipulate it the
the side when he manipulate it the
the side when he manipulate it the fractures healed if it does then it’s
fractures healed if it does then it’s
fractures healed if it does then it’s not healed 400 patients and stoke have
not healed 400 patients and stoke have
not healed 400 patients and stoke have been assessed with that now and it works
been assessed with that now and it works
been assessed with that now and it works beautifully no wise no computers but
beautifully no wise no computers but
beautifully no wise no computers but they still have to come back to clinic
they still have to come back to clinic
they still have to come back to clinic now are they walking where they’re
now are they walking where they’re
now are they walking where they’re supposed to or are they we don’t know
supposed to or are they we don’t know
supposed to or are they we don’t know when they go home so we started
when they go home so we started
when they go home so we started monitoring them at home there’s a little
monitoring them at home there’s a little
monitoring them at home there’s a little thing collect the data and we end up
thing collect the data and we end up
thing collect the data and we end up with the graph that looks like this at
with the graph that looks like this at
with the graph that looks like this at the beginning not very much is going on
the beginning not very much is going on
the beginning not very much is going on because it
because it
because it at the end it’s tailing off because the
at the end it’s tailing off because the
at the end it’s tailing off because the fractures healing but they still have to
fractures healing but they still have to
fractures healing but they still have to come back to clinic to get the data one
come back to clinic to get the data one
come back to clinic to get the data one we’re bagging on about this sixty
we’re bagging on about this sixty
we’re bagging on about this sixty percent of clinics involved someone just
percent of clinics involved someone just
percent of clinics involved someone just saying you’ll find come back in four
saying you’ll find come back in four
saying you’ll find come back in four weeks they’re redundant be much better
weeks they’re redundant be much better
weeks they’re redundant be much better if they don’t have to you could do that
if they don’t have to you could do that
if they don’t have to you could do that on the telephone so we’ve started going
on the telephone so we’ve started going
on the telephone so we’ve started going to Internet of Things technology there
to Internet of Things technology there
to Internet of Things technology there it is on someone’s what it would look
it is on someone’s what it would look
it is on someone’s what it would look like on someone’s leg and what it would
like on someone’s leg and what it would
like on someone’s leg and what it would look like when someone’s walking it will
look like when someone’s walking it will
look like when someone’s walking it will send the data up to a computer and that
send the data up to a computer and that
send the data up to a computer and that computer will then send the data back to
computer will then send the data back to
computer will then send the data back to the patient or the surgeon now if
the patient or the surgeon now if
the patient or the surgeon now if nothing’s awry and everything is going
nothing’s awry and everything is going
nothing’s awry and everything is going to plan does that patient have to come
to plan does that patient have to come
to plan does that patient have to come back to clinic no they can be rung up
back to clinic no they can be rung up
back to clinic no they can be rung up and said he’s going very well in fact
and said he’s going very well in fact
and said he’s going very well in fact they could look at it themselves tada
they could look at it themselves tada
they could look at it themselves tada sixty percent of clinics gone sixty
sixty percent of clinics gone sixty
sixty percent of clinics gone sixty percent of clinics gone means that
percent of clinics gone means that
percent of clinics gone means that people don’t have to take days off work
people don’t have to take days off work
people don’t have to take days off work to take their friends or brothers or
to take their friends or brothers or
to take their friends or brothers or sisters in the hospital sixty percent of
sisters in the hospital sixty percent of
sisters in the hospital sixty percent of clinics gone means is less traffic less
clinics gone means is less traffic less
clinics gone means is less traffic less traffic means is more parking less
traffic means is more parking less
traffic means is more parking less traffic means there’s less co2 emission
traffic means there’s less co2 emission
traffic means there’s less co2 emission and the number is enormous for a clinic
and the number is enormous for a clinic
and the number is enormous for a clinic that’s the estimate for one clinic for
that’s the estimate for one clinic for
that’s the estimate for one clinic for one year now I’ve gone full circle now
one year now I’ve gone full circle now
one year now I’ve gone full circle now because at the beginning i was using
because at the beginning i was using
because at the beginning i was using complex equations to model power
complex equations to model power
complex equations to model power stations i now use those same equations
stations i now use those same equations
stations i now use those same equations to model how fractures heal in the late
to model how fractures heal in the late
to model how fractures heal in the late 80s Early 90s actually went to an
80s Early 90s actually went to an
80s Early 90s actually went to an esteemed panel or I proposed that we
esteemed panel or I proposed that we
esteemed panel or I proposed that we could connect all the power stations
could connect all the power stations
could connect all the power stations together in the world send the data to a
together in the world send the data to a
together in the world send the data to a host computer and that host computer
host computer and that host computer
host computer and that host computer would analyze all of that and better
would analyze all of that and better
would analyze all of that and better predict what was going on I was laughed
predict what was going on I was laughed
predict what was going on I was laughed out of the room they’ll went Sydney data
out of the room they’ll went Sydney data
out of the room they’ll went Sydney data over the ether are you mad well if only
over the ether are you mad well if only
over the ether are you mad well if only they could see me now boy am I glad I
they could see me now boy am I glad I
they could see me now boy am I glad I answered that phone thank
answered that phone thank
answered that phone thank [Applause]
”
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