Objective To evaluate clinical efficacy of four-claw Ti-planes for internal fixation of multiple rib fractures and flail chest. Methods Clinical data of 93 patients with multiple rib fractures and flail chest who were admittedto Shanghai Pudong Hospital from December 2011 to November 2012 were retrospectively analyzed. There were 78 male and 15 female patients with their age of 20-80 years. All the patients received internal fixation of rib fractures using four-clawTi-planes. Finite element modeling and analysis were performed to investigate biomechanical behaviors of rib fractures after internal fixation with four-claw Ti-planes. Results The average number of rib fractures of the 93 patients was 5.9±2.1,and each patient received 3.8±1.3 four-claw Ti-planes for internal fixation. The operations were performed 6.3±3.2 days after admission. After the rib fractures were fixed with four-claw Ti-planes,rib dislocations and chest-wall collapse of flail chest were restored,and patients’ pain was relieved. Postoperative CT image reconstruction of the chest showed no dislocationor displacement at the fixation areas of the four-claw Ti-planes. Rib fractures were stabilized well,and normal contours of the chest were restored. Finite element analysis showed that the maximum bearable stress of the rib fractures after internal fixation with four-claw Ti-planes was twice as large as normal ribs. Conclusion Clinical outcomes of four-claw Ti-planesfor internal fixation of rib fractures are satisfactory with small incisions and less muscle injury of the chest wall,so this technique deserves wide clinical use.
Citation:
WANG Changtao,WANG Shengzhang,WANG Weizhong,XU Yongdong,WANG Dongdong,LI Zhicheng,XIONG Jian.. Finite Element Modeling and Clinical Analysis of Internal Fixation of Multiple Rib Fractures and Flail Chest Using Four-claw Ti-planes. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2013, 20(5): 551-554. doi: 10.7507/1007-4848.20130172
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Copyright © the editorial department of Chinese Journal of Clinical Thoracic and Cardiovascular Surgery of West China Medical Publisher. All rights reserved
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苏泓洁, 都定元, 赵兴吉, 等. 连枷胸的诊治进展. 创伤外科杂志, 2008, 10 (4):368-370.
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Bottlang M, Helzel I, Long WB, et al. Anatomically contoured plates for fixation of rib fractures. J Trauma, 2010, 68 (3):611-615.
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Li Z, Kindig MW, Kerrigan JR, et al. Rib fractures under anterior-posterior dynamic loads:experimental and finite-element study. J Biomech, 2010, 43 (2):228-234.
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Li Z, Kindig MW, Subit D, et al. Influence of mesh density, corticalthickness and material properties on human rib fracture prediction. Med Eng Phys, 2010, 32 (9):998-1008.
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Mohr M, Abrams E, Engel C, et al. Geometry of human ribs pertinent to orthopedic chest-wall Reconstruction. J Biomech, 2007, 40 (6):1310-1317.
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Bottlang M, Walleser S, Noll M, et al. Biomechanical rationale and evaluation of an implant system for rib fracture fixation. Eur J Trauma Emerg Surg, 2010, 36 (5):417-426.
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Osinowo OA, Zahrani M, Softa A. Effect of intercostal nerve block with 0. 5%bupivacaine on peak expiratory flow rate and arterial oxygensaturation in rib fractures.J Trauma, 2004, 56 (2):345-347.
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Oyarzun JR, Bush AP, McCormick JR, et al. Use of 3.5-mm aceta-bular Reconstruction plates for internal fixation of flail chest injuries.Ann Thorac Surg, 1998, 65 (5):1471-1474.
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- 1. 王彦, 葛明. 纯钛肋骨爪型接骨板在多发性肋骨骨折中的运用. 实用临床医药杂志, 2008, 12 (5):63-64.
- 2. 吴伟敏, 张剑平, 姜敏炎, 等. 肋骨爪形钢板内固定治疗外伤性浮动胸壁. 中华胸心血管外科杂志, 2005, 21 (1):23.
- 3. 何明, 周灵飞, 马双慰, 等. 多发性肋骨骨折的内固定治疗. 重庆医学, 2006, 35 (16):1531-1532.
- 4. 王珏, 王建利, 陈刚, 等. 可吸收肋骨钉治疗多发性肋骨骨折. 中国基层医药, 2007, 14 (6):918-919.
- 5. 石爱群, 高宏彦, 赵元生, 等. 可吸收肋骨钉治疗多发性肋骨骨折26例分析. 山西医药杂志, 2009, 38 (11):1030-1031.
- 6. 廖海浪, 杨文彬, 王成日, 等. 形状记忆合金环抱器治疗肋骨骨折的临床评价. 中国骨与关节损伤杂志, 2007, 22 (8):685-686.
- 7. 刘俊清, 胡晓冬, 王科, 等. 可吸收髓内钉与形状记忆合金环抱器治疗多发肋骨骨折的疗效比较. 华北煤炭医学院学报, 2010, 12 (5):673.
- 8. 苏泓洁, 都定元, 赵兴吉, 等. 连枷胸的诊治进展. 创伤外科杂志, 2008, 10 (4):368-370.
- 9. Bottlang M, Helzel I, Long WB, et al. Anatomically contoured plates for fixation of rib fractures. J Trauma, 2010, 68 (3):611-615.
- 10. Li Z, Kindig MW, Kerrigan JR, et al. Rib fractures under anterior-posterior dynamic loads:experimental and finite-element study. J Biomech, 2010, 43 (2):228-234.
- 11. Li Z, Kindig MW, Subit D, et al. Influence of mesh density, corticalthickness and material properties on human rib fracture prediction. Med Eng Phys, 2010, 32 (9):998-1008.
- 12. Mohr M, Abrams E, Engel C, et al. Geometry of human ribs pertinent to orthopedic chest-wall Reconstruction. J Biomech, 2007, 40 (6):1310-1317.
- 13. Bottlang M, Walleser S, Noll M, et al. Biomechanical rationale and evaluation of an implant system for rib fracture fixation. Eur J Trauma Emerg Surg, 2010, 36 (5):417-426.
- 14. Osinowo OA, Zahrani M, Softa A. Effect of intercostal nerve block with 0. 5%bupivacaine on peak expiratory flow rate and arterial oxygensaturation in rib fractures.J Trauma, 2004, 56 (2):345-347.
- 15. Oyarzun JR, Bush AP, McCormick JR, et al. Use of 3.5-mm aceta-bular Reconstruction plates for internal fixation of flail chest injuries.Ann Thorac Surg, 1998, 65 (5):1471-1474.