肋骨骨折是在急診室常見的損傷，其中最常發生胸部鈍傷，可能誘發肋骨二處或以上的部位發生骨折，成為連枷胸骨折。現階段有許多連枷胸的治療方法，傳統方法是使用機械呼吸器以及止痛劑等藥物來減少病患的疼痛程度，但當肋骨骨折患者因斷裂肋骨的過大位移，導致引發劇烈疼痛、影響呼吸與胸壁變形，執行外科骨板固定手術就顯得極其重要。近年來隨著醫療科技的進步，「鈦金屬骨板復位固定手術」已被證實可降低患者呼吸疼痛感，並縮短住院時間與降低胸腔創傷之併發症發生率。然而在臨床醫生對於打骨板的位置以及需要打幾根骨板
，都是透過自身過往實踐的經驗判斷，直到現在並沒有使用科學的方法來預測對肋骨骨折施打骨板合適的位置。
本研究使用有限元素分析的方法，針對連枷胸在不同的治療策略之結果來進行比較，透過電腦繪圖軟體在肋骨模型上設計骨板施打的位置，再藉由電腦模擬分析骨折處術後位移、術後肋骨呼吸時所產生的角度、骨折固定指標、骨板應力分布以及肋骨應力分布等等，做詳細的探討。在治療策略的參考組A與對照組B、 C、D之中，透過分析結果可發現擁有最少的骨折位移、最佳的固定指標，就是理想的治療策略，在基於此條件下，可發現當有單根肋骨前側(anterior)與後側(posterior)同時發生骨折時，可優先考慮前側施打骨板，也就是本研究G2骨板群，故在對照組當中，D為推薦的骨板施打治療策略。同時本研究也基於參考組與對照組的治療策略結果下，進而發展出特殊治療策略，其為E與F，施打骨板數量分別為6根與4根。利用特殊組治療策略將骨折後之懸浮端與固定端銜接，將連枷胸骨折簡化為一般肋骨骨折，大幅降低患術後骨折處位移，也就是減少患者呼吸疼痛機率增加，能幫助患者術後提早康復，同時還能降低施打的骨板數量，進而減少病患的手術費用負擔。
雖然臨床案例研究是最直接能夠了解肋骨骨折問題的評估方式，需要大量的案例收集與長期的評估時間，但透過有限元素分析方法可大幅省下不少時間以及空間成本。希望藉由數值結果後處理的方式，依據肋骨骨折固定指數、肋骨骨骼應力與骨板植體應力進行評估來找出最佳植入物治療策略組合，以提供醫師在臨床上選擇植入物位置的參考。

Rib fractures are common injuries in the emergency room, it may induce two or more parts of rib fractures to became a flail chest. Recently, with advances in medical technology, "Locked plate fixation" has been shown to reduce pain in patients with breathing, hospital stays, and incidence of complications of chest trauma. However, for the questions about how many fractures should be fixed with locked plates and how many numbers of the locked plate should be used in flail chest, which are determined through the experience of clinician. Until now, there is no study to predict suitable locations and numbers of locked plates for the treatment of flail chest by using finite element method.
In this study, three-dimensional finite element models of flail chest injury were developed using Solidworks and ANSYS Workbench. Six kinds of treatment strategies for the injury were evaluated and discussed. A respiratory movement was simulated as the loading condition. Both the pump-handle angle and bucket-handle angle were calculated and compared to the previous studies. In post-processing, the fixation index, implant stress, and bone stress were calculated to evaluate the strengths and limitations of different fixation scenarios.
The results showed that the anterior flail chest stabilization strategies revealed better mean fixation index than the posterior flail chest stabilization strategy. A fixation strategy with weak fixation index may increase the risk of implant failure. The use of different fixation strategies had a minor effect on the mean stress of the ribs. This finding revealed that the fixation index and implant stress have high priority in evaluation of various fixation strategies for flail chest injury. Numerical approach can greatly save time and cost compared to experimental approach. This study provides useful information for understanding the biomechanics of different fixation strategies for the treatment of flail chest injury.

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