Rib embracing fixators in the treatment of rib fractures and finite element modeling and analysis
Objective To explore the efficacy of rib embracing fixators in the treatment of rib fractures,and to evaluate the stress distribution by finite element(FE)analysis.Methods A retrospective study was conducted on 137 patients with multiple rib fractures,including 106 males and 31 females aged 25-62 years with an average age of 37.0 years.There were 64 cases of road traffic injuries,34 falls from height,12 ground-level falls,16 blunt force injuries,and 11 others.According to the treatment methods,patients were divided into control group(traditional ex-ternal fixation and conservative treatment,n=62)and observation group(rib embracing fixators,n=75).The time of mechanical ventilation,drainage tube removal,off-bed activities,hospital stay and fracture healing,VAS before and after treatment,dosage of analgesics,bone union and perioperative complications were recorded and compared be-tween two groups.Iterative reconstruction of the human thorax CT data was performed by using the Mimics software.Normal rib and fractured rib FE models after internal fixation by using the rib embracing device were established.FE analysis was performed by using the Abaqus 17.0 software,and the maximum displacement and stress response of the rib under three different loads were simulated and calculated.Results Compared with the control group,the observation group showed much shorter mechanical ventilation(d,6.1±1.3 vs.10.1±2.7),much quicker drainage tube removal(d,l.75±0.32 vs.3.73±0.67),off-bed activities(h,7.84±2.40 vs.12.58±3.03),hospital dis-charge(d,6.70±1.43 vs.10.05±3.66),and fracture healing(d,22.92±8.40 vs.35.73±9.95),much smaller postoperative VAS(3.3±0.9 vs.5.2±1.2)and less analgesic use(mg,63.1±19.5 vs.103.3±32.4,all P＜0.001).The excellent and good rate for bone union in the observation group was 97.3％,significantly higher than that in the control group(77.4％);while the incidence of pulmonary infection,atelectasis,and thoracic deformity in the observation group was significantly lower(P＜0.05).FE analysis showed that the rib fractures can withstand greater pressure after being fixed with a rib embracing fixator,the maximum displacement of the fracture was smaller than that of the normal rib,and the sectional clearance was＜0.01 mm.Conclusion The internal fixation of rib fractures by a rib embracing fixator can achieve good clinical outcomes.FE analysis also confirms that the rib em-bracing fixator has a good fixation performance from the perspective of biomechanics.It can ensure the stability of the fixed ribs.
Rib fracturesRib embracing fixatorInternal fixationFinite element analysis
NETL
NSTL
万方数据
维普
