Benedikt J Braun1, Tina Histing2, Steven C Herath2, Mika F R Rollmann2, Marie Reumann2, Maximilian M Menger2, Fabian Springer3, Annchristin Andres4, Stefan Diebels4, Michael Roland4. 1. Klinik für Unfall- und Wiederherstellungschirurgie, Eberhard Karls Universität Tübingen, BG Klinik Tübingen, Schnarrenbergstr. 95, 72072, Tübingen, Deutschland. bbraun@bgu-tuebingen.de. 2. Klinik für Unfall- und Wiederherstellungschirurgie, Eberhard Karls Universität Tübingen, BG Klinik Tübingen, Schnarrenbergstr. 95, 72072, Tübingen, Deutschland. 3. Klinik für Diagnostische und Interventionelle Radiologie, Eberhard Karls Universität Tübingen, Tübingen, Deutschland. 4. Lehrstuhl für Technische Mechanik, Universität des Saarlandes, Saarbrücken, Deutschland.
Abstract
BACKGROUND: The mechanical boundary conditions of the non-union and osteosynthetic construct are a key determinant of fracture healing after revision surgery. Aim of this study was to introduce a movement analysis and simulation workflow to determine the mechanical conditions during non-union healing in vivo. MATERIAL AND METHODS: On an individual case basis after non-union revision surgery we performed an accelerometry-based movement analysis. The results were then used as input for a musculoskeletal simulation of the non-union, osteosynthetic construct as well as adjacent joints mechanical boundary conditions. RESULTS: A total of 13 patients were analyzed with our new workflow. The introduced protocol allows an in vivo determination of the mechanical boundary conditions. On clinical follow-up all patients showed radiographic consolidation of the non-union. CONCLUSION: The introduced workflow allows a clinically applicable determination of the mechanical boundary conditions of fracture and non-union healing. Further studies can now determine the effect of the introduced technique for mechanically optimized postoperative aftercare regimes as well as biomechanically adapted surgical treatment.
BACKGROUND: The mechanical boundary conditions of the non-union and osteosynthetic construct are a key determinant of fracture healing after revision surgery. Aim of this study was to introduce a movement analysis and simulation workflow to determine the mechanical conditions during non-union healing in vivo. MATERIAL AND METHODS: On an individual case basis after non-union revision surgery we performed an accelerometry-based movement analysis. The results were then used as input for a musculoskeletal simulation of the non-union, osteosynthetic construct as well as adjacent joints mechanical boundary conditions. RESULTS: A total of 13 patients were analyzed with our new workflow. The introduced protocol allows an in vivo determination of the mechanical boundary conditions. On clinical follow-up all patients showed radiographic consolidation of the non-union. CONCLUSION: The introduced workflow allows a clinically applicable determination of the mechanical boundary conditions of fracture and non-union healing. Further studies can now determine the effect of the introduced technique for mechanically optimized postoperative aftercare regimes as well as biomechanically adapted surgical treatment.
Authors: Raphael P H Meier; Yvonne Kelly; Seiji Yamaguchi; Hillary J Braun; Tyler Lunow-Luke; Dieter Adelmann; Claus Niemann; Daniel G Maluf; Zachary C Dietch; Peter G Stock; Sang-Mo Kang; Sandy Feng; Andrew M Posselt; James M Gardner; Shareef M Syed; Ryutaro Hirose; Chris E Freise; Nancy L Ascher; John P Roberts; Garrett R Roll Journal: Front Surg Date: 2022-01-05