Fracture Fixation Biomechanics Simulator with Adaptive Virtual Coaching

项目摘要 获得适当的生物力学稳定性以促进愈合是骨折固定手术的首要目标 程序。低于标准的骨折固定可导致骨折不愈合、残留畸形、内固定失败、废弃。 萎缩、骨质疏松症和短期或长期残疾。患者出现不同的骨折几何形状，骨骼 质量，活动水平。外科医生在植入物的类型、大小、材料、结构配置、 术后负重策略。所有这些因素，以及患者天生的骨折愈合 能力，影响术后生物力学和由此产生的临床结果。社区骨科医生 那些不是创伤专家的人经常需要治疗这些骨折。尽管外科技术已经收到了 在医学模拟文献中，人们越来越多地认识到模拟的重要性 在手术的认知和决策方面。拟议的项目开发并测试了一种新的 交互式模拟软件，使外科医生能够更改患者变量和骨折固定 计划，并立即可视化这些变化如何影响临床重要的3D生物力学。技术 是由我们用于生成预计算结果库的高通量模拟方法实现的。这个 该项目依赖于学术生物医学工程师和临床科学家之间的密切长期合作， 通过与领先的开源可视化软件研发合作而得到增强 组织。该项目测试了一种假设，即骨折中三维生物力学的交互可视化 固定将提高生物力学知识和骨折固定计划。特定目标1开发和测试 改进的模拟软件与讲师指导的课程相结合，对3D教育的有效性 骨折固定生物力学。丰富的界面将包括经过验证的三个参数模拟 基本骨折固定类型(桥式钢板、加压钢板和髓内钉)应用于 包括简化骨骼和股骨近端骨折。特定目标2引入了一种自主、自适应的虚拟 Coach集成到了软件中。虚拟教练将为每位外科医生提供灵活、个性化的培训 根据他们的进展。该项目将提供新的、令人兴奋的机会，提供更深层次的生物力学 对创造骨折内固定结构的外科医生的理解，促进精确医学和 推广更安全、更有效的外科手术。

Project Summary Obtaining proper biomechanical stability to promote healing is a primary goal of fracture fixation surgical procedures. Subpar fracture fixation can result in fracture nonunion, residual deformity, implant failure, disuse atrophy, osteopenia, and short or long-term disability. Patients present with variable fracture geometries, bone quality, activity level. Surgeons have many choices for implant types, sizes, materials, construct configurations, and postoperative weightbearing strategies. All these factors, as well as the patient’s innate fracture healing capacity, affect postoperative biomechanics and resulting clinical outcome. Community orthopaedic surgeons who are not trauma specialists often need to treat these fractures. Although surgical technique has received much attention in the medical simulation literature, there is increased recognition of the importance of simulation in the cognitive and decision-making aspects of surgery. The proposed project develops and tests a new interactive simulation software that enables a surgeon to make changes to patient variables and fracture fixation plan, and immediately visualize how these changes affect clinically important 3D biomechanics. The technology is enabled by our high-throughput simulation approaches for generation of precomputed results libraries. The project relies on close long-term collaborations between academic biomedical engineers and clinician scientists, enhanced by collaboration with a leading open-source visualization software research and development organization. The project tests the hypothesis that interactive visualization of 3D biomechanics in fracture fixation will improve biomechanical knowledge and fracture fixation plans. Specific Aim 1 develops and tests effectiveness of a refined simulation software, combined with an instructor-led session, for education of 3D fracture fixation biomechanics. The rich interface will include validated parametric simulations of three fundamental fracture fixation types (bridge plating, compression plating, and intramedullary nailing) applied to both simplified bones and to proximal femur fractures. Specific Aim 2 introduces an autonomous, adaptive virtual coach integrated into the software. The virtual coach will enable flexible, personalized training for each surgeon based on their progress. The project will provide new, exciting opportunities for providing deeper biomechanical understanding to the surgeons who create fracture fixation constructs, facilitating precision medicine and promoting safer and more effective surgical procedures.