Mechanical competence of proximal tibia in persons with spinal cord injury: development of a computational framework to quantify torsional and compressive stiffness and strength.

This study developed a framework to quantify the mechanical competence of the proximal tibia in spinal cord injury (SCI) and able-bodied (AB) participants. We created subject-specific finite element models of 53 proximal tibias (22 SCI, 5 AB) and quantified two torsional (stiffness, Kt and ultimate strength, Tult) and two compressive (stiffness, Kc and ultimate strength, Cult) metrics. We report the distributions of Kt, Tult, Kc, and Cult, and a minimum number of metrics required to quantify the mechanical competence of the proximal tibia. This work provides a foundation for confidence interval-based thresholds to predict fracture risk in persons with SCI.