title: Clinical implementation of finite element models in pelvic ring surgery for prediction of implant behavior: a case report.
abstract: BACKGROUND
  Osteosyntheses to stabilize pelvic-ring fractures were developed for younger patients, and are not universally indicated for elderly people. We present the results of parallel-arranged numerical simulations of fixation treatment that an elderly patient with a bagatelle-injured pelvic ring fracture received using a patient-specific finite element model.
  
  
  METHODS
  The clinical course of an osteosynthetic stabilized pelvic ring fracture, based on an actual case, was numerically simulated using a patient-specific finite element model.
  
  
  RESULTS
  A previously validated finite element model of a human pelvis was customized with computed tomography data from a patient with a stabilized pelvic-ring fracture. Numerical simulation was used to analyze primary stability. The clinical process, represented by radiologic examinations, was compared with the results from the finite element simulation. Implant loosening as well as newly-occurring fractures were shown to coincide with regions with the highest stress levels.
  
  
  CONCLUSIONS
  The results from the patient-specific finite element model closely resembled the actual clinical course especially in terms of the location of high strain concentration and subsequent implant loosening. This indicates that patient-specific finite element models have a potential to play an important role in planning osteosynthesis according to biomechanical stability.
authors: Department of Trauma, Plastic and Reconstructive Surgery, University of Leipzig, Liebigstr. 20, 04103 Leipzig, Germany.
authors: J
authors: J
authors: Böhme
authors: V
authors: V
authors: Shim
authors: A
authors: A
authors: Höch
authors: M
authors: M
authors: Mütze
authors: C
authors: C
authors: Müller
authors: C
authors: C
authors: Josten
mesh_terms: D000368:Aged; D003198:Computer Simulation; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D050723:Fractures, Bone / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D008954:Models, Biological; D010384:Pelvic Bones / Q000293:injuries* / Q000503:physiopathology* / Q000601:surgery; D011379:Prognosis; D017755:Prosthesis Fitting / Q000379:methods; D025321:Surgery, Computer-Assisted / Q000379:methods; D016896:Treatment Outcome