Lateral Cortical Fixation as the Optimal Strategy for Achieving Stability in Rib Fractures: A Patient-Specific Finite Element Analysis

The surgical stabilization of rib fractures helps maintain chest wall stability and reduces respiratory complications. This study aimed to identify the key biomechanical parameters for evaluating the stability of rib fracture fixation using finite element analysis (FEA) and compare four rib fixation...

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Main Authors: Xiang Zhang, Xuejun Lan, Wang Shen, Qinghua Zhou
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Bioengineering
Subjects:
Online Access:https://www.mdpi.com/2306-5354/12/6/594
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author Xiang Zhang
Xuejun Lan
Wang Shen
Qinghua Zhou
author_facet Xiang Zhang
Xuejun Lan
Wang Shen
Qinghua Zhou
author_sort Xiang Zhang
collection DOAJ
description The surgical stabilization of rib fractures helps maintain chest wall stability and reduces respiratory complications. This study aimed to identify the key biomechanical parameters for evaluating the stability of rib fracture fixation using finite element analysis (FEA) and compare four rib fixation configurations—intramedullary rib splint (IRS), locking plate (LP), claw-shape plate, and intrathoracic plate (IP)—using biomechanical analysis. Forty patient-specific FEA models of fourth-rib fractures were constructed using the computed tomography scans of 10 patients. Maximum implant displacement (MID), maximum rib fracture displacement, maximum implant von Mises stress (MIVMS), maximum rib von Mises stress, maximum rib strain, and maximum interfragmentary gap (MIG) were assessed by simulating the anterior and posterior loads on the ribs during postoperative frontal collision. The fixation stabilities were evaluated using entropy scores. MIVMS, MIG, and MID exhibited the highest weighting coefficients. Lateral cortical fixation strategies, particularly LP configuration, demonstrated superior biomechanical performance compared with IRS and IP systems. The composite score of the LP was significantly higher than that of the other modalities. MIVMS, MIG, and MID were identified as critical parameters for evaluating the rib fracture fixation stability, and the lateral cortical fixation strategy (LP) enhanced the structural stability of rib fracture fixation.
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spelling doaj-art-fdc3998bd30c49b192904f1d7958e2352025-08-20T02:24:22ZengMDPI AGBioengineering2306-53542025-05-0112659410.3390/bioengineering12060594Lateral Cortical Fixation as the Optimal Strategy for Achieving Stability in Rib Fractures: A Patient-Specific Finite Element AnalysisXiang Zhang0Xuejun Lan1Wang Shen2Qinghua Zhou3Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, ChinaHealth Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu 610041, ChinaDepartment of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, ChinaDepartment of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, ChinaThe surgical stabilization of rib fractures helps maintain chest wall stability and reduces respiratory complications. This study aimed to identify the key biomechanical parameters for evaluating the stability of rib fracture fixation using finite element analysis (FEA) and compare four rib fixation configurations—intramedullary rib splint (IRS), locking plate (LP), claw-shape plate, and intrathoracic plate (IP)—using biomechanical analysis. Forty patient-specific FEA models of fourth-rib fractures were constructed using the computed tomography scans of 10 patients. Maximum implant displacement (MID), maximum rib fracture displacement, maximum implant von Mises stress (MIVMS), maximum rib von Mises stress, maximum rib strain, and maximum interfragmentary gap (MIG) were assessed by simulating the anterior and posterior loads on the ribs during postoperative frontal collision. The fixation stabilities were evaluated using entropy scores. MIVMS, MIG, and MID exhibited the highest weighting coefficients. Lateral cortical fixation strategies, particularly LP configuration, demonstrated superior biomechanical performance compared with IRS and IP systems. The composite score of the LP was significantly higher than that of the other modalities. MIVMS, MIG, and MID were identified as critical parameters for evaluating the rib fracture fixation stability, and the lateral cortical fixation strategy (LP) enhanced the structural stability of rib fracture fixation.https://www.mdpi.com/2306-5354/12/6/594rib fracturesurgical stabilization of ribbiomechanicsfinite element analysis
spellingShingle Xiang Zhang
Xuejun Lan
Wang Shen
Qinghua Zhou
Lateral Cortical Fixation as the Optimal Strategy for Achieving Stability in Rib Fractures: A Patient-Specific Finite Element Analysis
Bioengineering
rib fracture
surgical stabilization of rib
biomechanics
finite element analysis
title Lateral Cortical Fixation as the Optimal Strategy for Achieving Stability in Rib Fractures: A Patient-Specific Finite Element Analysis
title_full Lateral Cortical Fixation as the Optimal Strategy for Achieving Stability in Rib Fractures: A Patient-Specific Finite Element Analysis
title_fullStr Lateral Cortical Fixation as the Optimal Strategy for Achieving Stability in Rib Fractures: A Patient-Specific Finite Element Analysis
title_full_unstemmed Lateral Cortical Fixation as the Optimal Strategy for Achieving Stability in Rib Fractures: A Patient-Specific Finite Element Analysis
title_short Lateral Cortical Fixation as the Optimal Strategy for Achieving Stability in Rib Fractures: A Patient-Specific Finite Element Analysis
title_sort lateral cortical fixation as the optimal strategy for achieving stability in rib fractures a patient specific finite element analysis
topic rib fracture
surgical stabilization of rib
biomechanics
finite element analysis
url https://www.mdpi.com/2306-5354/12/6/594
work_keys_str_mv AT xiangzhang lateralcorticalfixationastheoptimalstrategyforachievingstabilityinribfracturesapatientspecificfiniteelementanalysis
AT xuejunlan lateralcorticalfixationastheoptimalstrategyforachievingstabilityinribfracturesapatientspecificfiniteelementanalysis
AT wangshen lateralcorticalfixationastheoptimalstrategyforachievingstabilityinribfracturesapatientspecificfiniteelementanalysis
AT qinghuazhou lateralcorticalfixationastheoptimalstrategyforachievingstabilityinribfracturesapatientspecificfiniteelementanalysis