Three-dimensional simulation of fracture repair in the human tibia.

Finite element models of bones can be generated based on images obtained non-invasively in the clinic. One area where such models may prove useful is in the assessment of fracture healing of long bones. To establish the feasibility of such a proposal, a three dimensional finite element model of a fractured tibia was generated, and a model of tissue differentiation and bone regeneration was used to simulate the progress of healing under two different loading magnitudes. Healing is successful under the lower load and unsuccessful under the higher load--this proves that the model has the potential to identify loads that would cause healing to fail. Following a proposal by Richardson et al. [J. Bone Jt Surg. Vol. 76B (1994) pp. 389-394] that the bending stiffness can be used to assess the extent of healing, the bending stiffness was computed during healing--it was shown that the stiffness changed in a similar manner that observed clinically. In conclusion, the paper establishes that 3D computer simulation could be a tool for assessment of the fracture healing under different orthopedic treatments.