Development of biomechanical modeling subsystem for the medical decision support system in traumatology and orthopedics

Clinical recommendations for the treatment of diseases and injuries of the musculoskeletal system approved by the Russian Ministry of Health indicate the need for preoperative planning. Modern approaches imply the use of digitalisation tools in preoperative planning: starting from digital software and hardware complexes of radial diagnostics and ending with medical planning software that allows for radiometric measurements, selection of fixation structures and implants, virtual repositioning and installation of implant templates. Planning on radiographs or computed tomograms is based on the experience of the surgeon and, in terms of quantitative evaluation techniques, involves mainly techniques based on known anatomical relationships of normal anat-omy and physiology. A number of papers have proposed an approach to preoperative planning that includes biomechanical support for physician decision making. This approach is based pri-marily on the assessment of the stress-strain state that will occur in the system ‘bone - implant’ as a result of the planned treatment. This paper presents the results of the development of the bio-mechanical modelling subsystem of the medical decision support system in traumatology-ortho-paedics. Computer tomography data are taken as initial data. Computer tomograms are processed by means of artificial intelligence technologies for construction of solid-state models of biological objects. The methods of computational meshes construction by means of Ansys and NetGen sys-tems and biomechanics problem solving by means of finite element method of Ansys and NGSolve packages are applied. The developed subsystem partially automates the procedure of building the solid model of the system ‘bone - implant’ on the basis of computer tomogram, allows to perform the statement of the biomechanics problem, computational grid construction, numerical solution of the biomechanics problem by the finite element method, as well as visualisation and interpretation of the calculation results. The paper describes step-by-step a typical procedure of biomechanical modelling, presents the system structure, typical data flow and description of each of the subsys-tem modules responsible for the corresponding stages of the process. In addition to the main mod-ules, infrastructure modules responsible for data storage and organisation of interaction between software components are described. The software implementation of the subsystem is presented. Approbation on calculation tasks in spine and pelvic surgery is carried out.