四孔螺钉肋骨接骨板治疗多发性肋骨骨折的力学分析

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

目的分析自主设计开发的新型四孔螺钉肋骨接骨板在治疗多发性肋骨骨折中的力学特性并验证其临床疗效。方法使用有限元方法,分析四孔螺钉肋骨接骨板固定后断骨的最大位移与骨折断面间隙,并与目前临床常用的六爪肋骨接骨板的固定效果进行对比,最后回顾临床数据验证其治疗多发性肋骨骨折的临床疗效。结果有限元分析结果表明,使用四孔螺钉肋骨接骨板固定后,断骨的最大位移降低,断面间隙缩小,固定效果优于六爪肋骨接骨板。但螺钉孔处存在应力集中,可能会损伤皮质骨。回顾分析复旦大学附属浦东医院30例使用四孔螺钉肋骨接骨板治疗多发性肋骨骨折的临床资料,术后患者胸痛症状明显减轻,呼吸恢复顺畅,术后CT显示骨折复位良好,验证了四孔螺钉肋骨接骨板的临床疗效。结论四孔螺钉肋骨接骨板对断骨固定良好,且对于大曲率肋骨的骨折情形适用性强,适用于治疗多发性肋骨骨折。

Objective To analyze the mechanical properties of a new four-hole screw rib plate designed and developed independently 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 was compared the fixation efficacy with the current clinical commonly used six-claw rib plate.Finally,the clinical data was reviewed to confirm 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 might damage the cortical bone.Clinical data of 30 cases of multiple rib fractures treated with four-hole screw rib plate in Fudan University Pudong Medical Center 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.