Individual postoperative and preoperative workflow for patients with fractures of the lower extremities.

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-03-22 DOI:10.1016/j.clinbiomech.2025.106503

Annchristin Andres, Michael Roland, Kerstin Wickert, Bergita Ganse, Tim Pohlemann, Marcel Orth, Stefan Diebels

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引用次数: 0

Abstract

Background: The individual assessment of the postoperative healing situation contributes significantly to detecting healing disorders, ensuring the mechanical stability of implants, and planning revision surgeries.

Methods: Our established workflow consists of the following steps: (1) Monitoring of the patients during their treatment course with a motion capturing system as kinematic and sensor insoles for the kinetic gait analysis, (2) transfer of the motion data into the musculoskeletal simulation system AnyBody™ to achieve the corresponding individual muscle and joint forces. (3) Clinical imaging of the patients via postoperative computed tomography scans, ideally combined with a six-rod bone density calibration phantom. (4) Segmentation of the CT images and generation of the corresponding adaptive finite element meshes of the bone-implant systems, including the material parameters based on Hounsfield units and calibration phantom via the software ScanIP™. (5) Based on the patient-specific model, all information from the musculoskeletal simulation and gait analysis is transferred to our biomechanical simulation process as patient-specific constraints.

Findings: This workflow allows us to simulate individual patient models based on their respective actual motion data over their treatment course. Thus, pathological processes that may lead to non-healing fractures can be detected early after surgery and prevented by adapting the postoperative treatment protocol. Furthermore, it is possible to understand the forces that affect the fracture and its healing process permanently in more detail.

Interpretation: The findings demonstrate that the individual motion parameters and fracture morphology influence the local healing parameters and create individual weight-bearing recommendations.

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.