北京生物醫(yī)學(xué)工程

四孔螺釘肋骨接骨板治療多發(fā)性肋骨骨折的力學(xué)分析

Mechanical analysis of four-hole screw rib plate in the treatment of multiple rib fractures

作者：黎健明王冬冬王曉奇王長(zhǎng)濤王盛章

單位：復(fù)旦大學(xué)航空航天系(上海 200433) 復(fù)旦大學(xué)附屬浦東醫(yī)院胸外科(上海 201399）

關(guān)鍵詞：四孔螺釘肋骨接骨板; 多發(fā)性肋骨骨折; 內(nèi)固定; 有限元分析

分類號(hào)：R318.01

出版年·卷·期（頁(yè)碼）：2021·40·2（111-116）

摘要：

目的自主設(shè)計(jì)開發(fā)新型四孔螺釘肋骨接骨板，分析其在治療多發(fā)性肋骨骨折中的力學(xué)特性并驗(yàn)證臨床療效。方法使用有限元方法，分析四孔螺釘肋骨接骨板固定后斷骨的最大位移與骨折斷面間隙，并與目前臨床常用的六爪肋骨接骨板的固定效果進(jìn)行對(duì)比，最后回顧臨床數(shù)據(jù)驗(yàn)證其治療多發(fā)性肋骨骨折的臨床療效。結(jié)果有限元分析結(jié)果表明,使用四孔螺釘肋骨接骨板固定后，斷骨的最大位移降低，斷面間隙縮小，固定效果優(yōu)于六爪肋骨接骨板。但螺釘孔處存在應(yīng)力集中，可能會(huì)損傷皮質(zhì)骨。回顧分析復(fù)旦大學(xué)附屬浦東醫(yī)院30例使用四孔螺釘肋骨接骨板治療多發(fā)性肋骨骨折的臨床資料，術(shù)后患者胸痛癥狀明顯減輕，呼吸恢復(fù)順暢，術(shù)后CT顯示骨折復(fù)位良好，驗(yàn)證了四孔螺釘肋骨接骨板的臨床療效。結(jié)論四孔螺釘肋骨接骨板對(duì)斷骨固定良好，且對(duì)于大曲率肋骨的骨折情形適用性強(qiáng)，適用于治療多發(fā)性肋骨骨折。

Objective A new four-hole screw rib plate was designed and developed independently, the goal of this paper was to analyze its mechanical properties in the treatment of multiple rib fractures and verify the clinical efficacy. Methods Finite element method was used to analyze the maximum displacement of broken ribs and fracture section gap after the fixation with four-hole screw rib plate, and then compared the fixation efficacy with the current clinical commonly used six-claw rib plate. Finally, the clinical data was reviewed to confirmed the clinical effect of the plate in the treatment of multiple rib fractures. Results The results of finite element analysis showed that the maximum displacement of the broken ribs was reduced and the fracture section gap was reduced after fixation with four-hole screw rib plate, and the fixation efficacy was better than that of the six-claw rib plate. However, the stress concentration at the screw hole may damage the cortical bone. Clinical data of 30 cases of multiple rib fractures treated with four-hole screw rib plate in Shanghai Pudong Hospital of Fudan University were retrospectively analyzed. The chest pain of the patients was obviously relieved after the operation, and the respiratory recovery was smooth. Postoperative CT reconstruction of the chest showed good restoration of the rib fractures, which verified the clinical efficacy of four-hole screw rib plate. Conclusions The four-hole screw rib plate has good fixation property for the broken ribs, and can be adaptive to rib fracture with large curvature, which make it suitable for the treatment of multiple rib fractures.

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