An optimization algorithm for individualized biomechanical analysis and simulation of tibia fractures.

An algorithmic strategy to determine the minimal fusion area of a tibia pseudarthrosis to achieve mechanical stability is presented. For this purpose, a workflow capable for implementation into clinical routine workup of tibia pseudarthrosis was developed using visual computing algorithms for image segmentation, that is a coarsening protocol to reduce computational effort resulting in an individualized volume-mesh based on computed tomography data. An algorithm detecting the minimal amount of fracture union necessary to allow physiological loading without subjecting the implant to stresses and strains that might result in implant failure is developed. The feasibility of the algorithm in terms of computational effort is demonstrated. Numerical finite element simulations show that the minimal fusion area of a tibia pseudarthrosis can be less than 90% of the full circumferential area given a defined maximal von Mises stress in the implant of 80% of the total stress arising in a complete pseudarthrosis of the tibia.