Purpose::Rib fractures are one of the most common causes of morbidity and mortality and are associated with abdominal solid organ injury(ASOI).The purpose of this study was to investigate the correlation of ASOI with ...Purpose::Rib fractures are one of the most common causes of morbidity and mortality and are associated with abdominal solid organ injury(ASOI).The purpose of this study was to investigate the correlation of ASOI with the number,location,and involved segments of rib fracture(s)in blunt chest trauma.Methods::This retrospective cohort study was conducted on patients with blunt chest trauma over the age of 15 years,who were hospitalized with the diagnosis of rib fractures from July 2015 to September 2020.After ethic committee approval,a retrospective chart review was designed and patients with a diagnosis of rib fractures were selected.Patients who had chest and abdominopelvic CT scan were included in the study and additional data including age,gender,injury severity score,trauma mechanism,number and sides of the fractured ribs(left/right/bilateral),rib fracture segments(upper,middle,lower zone)and results of chest and abdominal spiral CT scan were recorded.The correlation between ASOI and the sides,segments and number of rib fracture(s)was assessed by Pearson's correlation coefficient.Results::Altogether 1056 patients with rib fracture(s)were included.The mean age was(42.76±13.35)years and 85.4%were male.The most common mechanism of trauma was car accident(34.6%).Most fractures occurred in the middle rib zone(60.44%)and the most commonly involved ribs were the 6th and 7th ones(15.7%and 16.4%,respectively).Concurrent abdominal injuries were observed in 103 patients(34.91%)and were significantly associated with middle zone rib fractures.Conclusion::There is a significant relationship between middle zone rib fractures and ASOI.Intra-abdominal injuries are not restricted to fractures of the lower ribs and thus should always be kept in mind during management of blunt trauma patients with rib fractures.展开更多
本研究利用有限元法对拳击、胸外按压致肋骨骨折进行模拟,以期为肋骨骨折致伤方式分析提供一种可视化、可量化的辅助技术。通过采用有限元法分别模拟:1)设置拳头模型以6 m/s击打THUMS4.02(Total Human Model for Safety 4.02)人体模型...本研究利用有限元法对拳击、胸外按压致肋骨骨折进行模拟,以期为肋骨骨折致伤方式分析提供一种可视化、可量化的辅助技术。通过采用有限元法分别模拟:1)设置拳头模型以6 m/s击打THUMS4.02(Total Human Model for Safety 4.02)人体模型的左胸;2)设置按压锤模型以400 N竖直向下的力按压THUMS4.02人体模型的心前区。比较二者模拟结果的肋骨骨折分布、形态特点,从生物力学角度分析二者的损伤机制,并将模拟结果与文献报道进行比较。模拟结果显示:1)肋骨骨折形态、分布:拳击致肋骨骨折的断端形态为向内弯曲,分布于直接击打处;按压胸部致肋骨骨折的断端形态为向外翻折,分布在肋骨非直接受力处。2)生物力学响应:拳击胸部时,应变集中分布在拳击肋骨处,击打处肋骨外侧面产生压应力,内侧面产生拉应力。按压胸部时,除按压处存在应变分布外,按压侧的肋骨腋前线处出现明显应变分布,腋前线处肋骨外侧面产生拉应力,内侧面产生压应力。本研究模拟结果均得到文献支持,提示利用有限元法可实现对肋骨骨折致伤方式可视化、可量化的辅助性分析与解释。展开更多
文摘Purpose::Rib fractures are one of the most common causes of morbidity and mortality and are associated with abdominal solid organ injury(ASOI).The purpose of this study was to investigate the correlation of ASOI with the number,location,and involved segments of rib fracture(s)in blunt chest trauma.Methods::This retrospective cohort study was conducted on patients with blunt chest trauma over the age of 15 years,who were hospitalized with the diagnosis of rib fractures from July 2015 to September 2020.After ethic committee approval,a retrospective chart review was designed and patients with a diagnosis of rib fractures were selected.Patients who had chest and abdominopelvic CT scan were included in the study and additional data including age,gender,injury severity score,trauma mechanism,number and sides of the fractured ribs(left/right/bilateral),rib fracture segments(upper,middle,lower zone)and results of chest and abdominal spiral CT scan were recorded.The correlation between ASOI and the sides,segments and number of rib fracture(s)was assessed by Pearson's correlation coefficient.Results::Altogether 1056 patients with rib fracture(s)were included.The mean age was(42.76±13.35)years and 85.4%were male.The most common mechanism of trauma was car accident(34.6%).Most fractures occurred in the middle rib zone(60.44%)and the most commonly involved ribs were the 6th and 7th ones(15.7%and 16.4%,respectively).Concurrent abdominal injuries were observed in 103 patients(34.91%)and were significantly associated with middle zone rib fractures.Conclusion::There is a significant relationship between middle zone rib fractures and ASOI.Intra-abdominal injuries are not restricted to fractures of the lower ribs and thus should always be kept in mind during management of blunt trauma patients with rib fractures.
文摘本研究利用有限元法对拳击、胸外按压致肋骨骨折进行模拟,以期为肋骨骨折致伤方式分析提供一种可视化、可量化的辅助技术。通过采用有限元法分别模拟:1)设置拳头模型以6 m/s击打THUMS4.02(Total Human Model for Safety 4.02)人体模型的左胸;2)设置按压锤模型以400 N竖直向下的力按压THUMS4.02人体模型的心前区。比较二者模拟结果的肋骨骨折分布、形态特点,从生物力学角度分析二者的损伤机制,并将模拟结果与文献报道进行比较。模拟结果显示:1)肋骨骨折形态、分布:拳击致肋骨骨折的断端形态为向内弯曲,分布于直接击打处;按压胸部致肋骨骨折的断端形态为向外翻折,分布在肋骨非直接受力处。2)生物力学响应:拳击胸部时,应变集中分布在拳击肋骨处,击打处肋骨外侧面产生压应力,内侧面产生拉应力。按压胸部时,除按压处存在应变分布外,按压侧的肋骨腋前线处出现明显应变分布,腋前线处肋骨外侧面产生拉应力,内侧面产生压应力。本研究模拟结果均得到文献支持,提示利用有限元法可实现对肋骨骨折致伤方式可视化、可量化的辅助性分析与解释。
