Orthopedic reconstruction of blunt chest trauma can aid restoration of pulmonary function to reduce the mortality associated with serial rib fractures and flail chest injuries. Contemporary chest wall reconstruction requires contouring of generic plates to the complex surface geometry of ribs. This study established a biometric foundation to generate specialized, anatomically contoured osteosynthesis hardware for rib fracture fixation. On human cadaveric ribs three through nine, the surface geometry pertinent to anatomically conforming osteosynthesis plates was characterized by quantifying the apparent rib curvature C(A), the longitudinal twist alpha(LT) along the diaphysis, and the unrolled curvature C(U). In addition, the rib cross-sectional geometry pertinent to intramedullary fixation strategies was characterized in terms of cross-section height, width, area, and cortex thickness. The rib surface exhibited a curvature C(A) ranging from 3.8 m(-1) in the anteromedial section of rib seven to 17.3 m(-1) in the posterior section of rib three. All ribs had in common a longitudinal twist alpha(LT), ranging from 41-60 degrees. The unrolled curvature C(U) decreased gradually from ribs three to five, and increased gradually with reversed orientation from rib six to nine. The cross-sectional area remained constant along the rib diaphysis. However, the medullary canal increased in size from 29.9 mm(2) posteriorly to 41.2 mm(2) in anterior rib segments. Results of this biometric rib characterization describe a novel strategy for intraoperative plate contouring and provide a foundation for the development of specialized rib osteosynthesis strategies.

译文

:钝性胸部创伤的整形外科手术可以帮助恢复肺功能,从而降低与连续肋骨骨折和连fl胸伤相关的死亡率。当代的胸壁重建需要仿照普通板的轮廓以适应复杂的肋骨表面几何形状。这项研究建立了生物特征基础,以生成用于解剖肋骨骨折的专用的,解剖学上轮廓化的骨合成硬件。在三到九个人的尸体肋骨上,通过量化视在肋骨曲率C(A),沿骨干的纵向扭曲alpha(LT)和展开曲率C(U)来表征与解剖学上相符的骨合成板相关的表面几何形状。另外,与髓内固定策略有关的肋骨横截面几何形状以横截面高度,宽度,面积和皮质厚度为特征。肋骨表面的曲率C(A)在肋骨7的内侧区域中的范围为3.8 m(-1),在肋骨3的后部区域中的曲率C(A)为17.3 m(-1)。所有的肋骨都有一个共同的纵向扭曲α(LT),范围为41-60度。展开曲率C(U)从第3肋逐渐减小到第5肋,并随着从第6肋向第9肋的反向取向而逐渐增大。沿肋骨骨干的横截面面积保持恒定。但是,在前肋骨节段中,髓管的大小从后方的29.9 mm(2)增加到41.2 mm(2)。这种生物特征肋骨表征的结果描述了一种术中板轮廓的新策略,并为发展专门的肋骨合成策略提供了基础。

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