Movement analysis and musculoskeletal simulation in non-union treatment-Experiences and first clinical results

Abstract

The mechanical boundary conditions of the non-union and osteosynthetic construct are akey 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. 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 amusculoskeletal simulation of the non-union, osteosynthetic construct as well as adjacent joints mechanical boundary conditions. A total of 13patients 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. The introduced workflow allows aclinically 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.