Fracture Generation according to AO Classification: Exploring Freeform Software for Biomechanical Simulation and Virtual Reconstruction
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In the field of orthopedics and trauma surgery, the accurate classification and comprehension of fractures are pivotal for effective treatment planning and positive patient outcomes. The AO classification system, developed by the working group for osteosynthesis issues, has been categorized fractures based on anatomical location, severity, and specific fracture patterns [1]. Leveraging this classification method, we create virtual radius fractures, broadening the scope of biomechanical simulations and enhancing our insights into treatment options and healing processes. A significant challenge in biomechanical simulations is the scarcity of clinical imaging data, necessitating substantial effort for proper segmentation. This obstacle is effectively addressed with the support of Geomagic FreeformTM software. Within an existing clinical image dataset, the following radius fractures have been identified according to the AO classification: 2R3A2.1, 2R3A2.2, and 2R3A2.3 (see Figure 1). Our approach aims to foster a comprehensive understanding of fracture patterns, their biomechanical implications, and the potential of virtual reconstruction to enhance diagnostic and therapeutic strategies. The workflow comprises the following steps: (1) Utilizing freeform software and its specialized modeling tools to generate various fracture types. The radius is now divided into three bone segments: distal and proximal bone segments and the fracture itself. (2) Assigning material parameters to individual segments and passing the bone to a high-quality finite element mesh generator. (3) Biomechanical simulation involves defining subject-specific boundary conditions and applying force from the elbow joint to the proximal bone segment. The required joint force from the elbow is derived from our monitoring database. Braun et al.[2] outlines the procedure for a distal tibial shaft fracture. Similarly, the calculation of joint forces for the elbow can be approached analogously. By blending virtually generated fractures with subject-specific boundary conditions, we can create a diverse array of pertinent biomechanical simulations, thereby enriching our understanding of the fracture's biomechanics. The use of freeform software for biomechanical simulations and virtual reconstructions open new dimensions for research, promising a deeper understanding of fracture geometries and their clinical implications.