| Autor: |
Maisenbacher TC; Department of Trauma and Reconstructive Surgery, Eberhard Karls University Tuebingen, BG Klinik Tuebingen, 72076 Tuebingen, Germany., Libicher S; Department of Trauma and Reconstructive Surgery, Eberhard Karls University Tuebingen, BG Klinik Tuebingen, 72076 Tuebingen, Germany., Erne F; Department of Trauma and Reconstructive Surgery, Eberhard Karls University Tuebingen, BG Klinik Tuebingen, 72076 Tuebingen, Germany., Menger MM; Department of Trauma and Reconstructive Surgery, Eberhard Karls University Tuebingen, BG Klinik Tuebingen, 72076 Tuebingen, Germany., Reumann MK; Department of Trauma and Reconstructive Surgery, Eberhard Karls University Tuebingen, BG Klinik Tuebingen, 72076 Tuebingen, Germany., Schindler Y; Project Team OSORA-Medical Fracture Analytics, Ulm University, Helmholtzstr. 20, 89081 Ulm, Germany., Niemeyer F; Project Team OSORA-Medical Fracture Analytics, Ulm University, Helmholtzstr. 20, 89081 Ulm, Germany., Engelhardt L; Project Team OSORA-Medical Fracture Analytics, Ulm University, Helmholtzstr. 20, 89081 Ulm, Germany., Histing T; Department of Trauma and Reconstructive Surgery, Eberhard Karls University Tuebingen, BG Klinik Tuebingen, 72076 Tuebingen, Germany., Braun BJ; Department of Trauma and Reconstructive Surgery, Eberhard Karls University Tuebingen, BG Klinik Tuebingen, 72076 Tuebingen, Germany. |
| Abstrakt: |
Background: The healing potential of a fracture is determined by mechanical and biological factors. Simulation-based workflows can help assess these factors to assist in predicting non-unions. The aim of this study was the introduction of two use cases for a novel patient-specific simulation workflow based on clinically available information. Methods: The used software is an extension of the "Ulm Bone Healing model" and was applied in two cases with non-union development after fracture fixation to show its principal feasibility. The clinical and radiographic information, starting from initial treatment, were used to feed the simulation process. Results: The simulation predicted non-union development and axial deviation in a mechanically driven non-union. In the case of a biological non-union, a slow, incomplete healing course was correctly identified. However, the time offset in callus bridging was discordant between the simulation and the distinctly slower healing response in the clinical case. Conclusions : The simulation workflow presented in the two clinical use cases allowed for the identification of fractures at risk for impending non-union immediately after the initial fixation based on available clinical and radiographic information. Further validation in a large non-union cohort is needed to increase the model's precision, especially in biologically challenging cases, and show its validity as a screening instrument. |
