Biomechanical Effectivity Evaluation of Single- and Double-Metal-Bar Methods with Rotation and Equilibrium Displacements in Nuss Procedure Simulations.
Computer simulation
Double-bar method
Finite-element method
Nuss procedure
Pectus excavatum
Journal
Annals of biomedical engineering
ISSN: 1573-9686
Titre abrégé: Ann Biomed Eng
Pays: United States
ID NLM: 0361512
Informations de publication
Date de publication:
01 Feb 2024
01 Feb 2024
Historique:
received:
07
11
2023
accepted:
30
12
2023
medline:
2
2
2024
pubmed:
2
2
2024
entrez:
1
2
2024
Statut:
aheadofprint
Résumé
Surgical treatment of the pectus excavatum has led to the introduction of the Nuss procedure, a minimally invasive surgical procedure that involves inserting a metal bar under the sternum through a small lateral thoracic incision. An additional metal bar was inserted in patients with pectus excavatum to improve the retention of the restored chest wall after the Nuss procedure. However, a need still exists to analyze the mechanistic advantages and disadvantages of the double-bar method owing to the increased surgical time and proficiency. The purpose of this study is to compare and evaluate the efficiency of single- and double-bar methods using rotational and equilibrium displacement simulations of the Nuss procedure. A finite-element model was constructed for two types of metal bars inserted into the chest wall. Boundary conditions for the rotation and equilibrium displacements were set for the metal bar. The anterior sternal translation, Haller index and maximum equivalent stress and strain owing to the behavior of the metal bar were estimated and compared with the single-bar method and postoperatively acquired patient data. The simulation results showed that the influences of the intercostal muscle and equilibrium after rotation displacement were significant. The stresses and strains were distributed across the two metal bars, and the upper-metal bar was heavily loaded. The double-bar method was advantageous regarding the load distribution effects of the two metal bars on the chest wall. However, mechanical assessments are also important because an excessive load is typically applied to the upper-metal bar.
Identifiants
pubmed: 38302767
doi: 10.1007/s10439-024-03441-z
pii: 10.1007/s10439-024-03441-z
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Ministry of Science and ICT, South Korea
ID : NRF-2022R1F1A1066509
Organisme : Ministry of Science and ICT, South Korea
ID : RS-2023-00252034
Organisme : Ministry of Education
ID : NRF-2021R1I1A1A01055804
Informations de copyright
© 2024. The Author(s) under exclusive licence to Biomedical Engineering Society.
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