請參照英文摘要

Rib fracture is a common traumatic injury. There have been several technique for rib fracture management. In recent years, surgical rib fixation has been widely used to treat rib fracture. The fixation for all fracture is not necessary, therefore, surgeons only need to fix a certain number of fractures. However, the number of fractures need to fix and the fixation position were totally based on surgeon’s practical experience and there has been no scientific study solved this problem. The purpose of the present study was to develop a three dimensional thoracic wall to simulate the human respiratory process. Then the model is used to simulate the rib fracture treatment problem and figure out the optimal fixation position and the number of fixation fractures.
The solid model of the respiratory skeleton was fully developed. The finite element model consists of several respiratory muscles. The MatrixRIB fixation system (Synthes) was used in this study. Different fixation fracture combinations at several fixation positions were simulated for comparison. Three factors were used to evaluate the result, which are the total relative movement of two fracture pieces in each rib, the rib bone’s von Mises stress and the fixation plate’s von Mises stress.
The intact model was successfully meshed and validated by previous clinical study. All the treatment model shown a higher stability than the fracture model. For each number of fixation rib, the optimal fixation position was suggested. The global optimal fixation model for archiving the stability of thoracic wall was found.
In conclusion, the intact respiratory model is this study was successfully developed in this study. The current finite element model has capability to simulate the rib surgical fixation problem. The results from this study could provide sufficient information for surgeons to determine the number of fixation fracture and the fixation location.

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