Computational model of rib movement and its application in studying the effects of age-related thoracic cage calcification on respiratory system

Biomechanical investigation of different surgical strategies for the treatment of rib fractures using a three-dimensional human respiratory model

Rib fracture is a common injury and can result in pain during respiration. Conservative treatment of rib fracture is applied via mechanical ventilation. However, ventilator-associated complications frequently occur. Surgical fixation is another approach to treat rib fractures. Unfortunately, this surgical treatment is still not completely defined. Past studies have evaluated the biomechanics of the rib cage during respiration using a finite element method, but only intact conditions were modelled. Thus, the purpose of this study was to develop a realistic numerical model of the human rib cage and to analyse the biomechanical performance of intact, injured and treated rib cages. Three-dimensional finite element models of the human rib cage were developed. Respiratory movement of the human rib cage was simulated to evaluate the strengths and limitations of different scenarios. The results show that a realistic human respiratory movement can be simulated and the predicted results were closely related to previous study (correlation coefficient>0.92). Fixation of two fractured ribs significantly decreased the fixation index (191%) compared to the injured model. This fixation may provide adequate fixation stability as well as reveal lower bone stress and implant stress compared with the fixation of three or more fractured ribs.

Morphology, distribution, mineral density and volume fraction of human calcified costal cartilage

This study examines the properties of calcifying human costal cartilage and adjacent rib bone using qualitative and quantitative micro-computed tomography analysis. Calcifications are categorized with respect to location, microstructure, shape, and contiguity using a novel classification scheme and quantified in terms of mineral density, volume fraction, and length of infiltration from the costo-chondral junction (CCJ). Calcifications were present throughout the cartilage by location and ranged from small diffuse calcifications to nodes, rods, plates, and even large complex structures that exhibited a microstructural morphology similar to a cross-section of diaphysial bone, with a dense shell surrounding a trabecular core. Solid microstructure was most common for calcifications (44.5%), and the morphologies were found to vary with location, with rods and plates being most prevalent at the periphery (91.7% of all rods, 98.4% of all plates). The average mineral density of the calcifications over all locations and morphologies was 658.8±86.36, compared with 662.7±50.37 mgHA cm(-3) for the adjacent rib bone. The calcification volume fraction (6.54±4.71%) was less than the volume fraction of rib bone (21.62±6.44%). The length of contiguous calcification infiltrating from the CCJ into the costal cartilage, when present, was 19.21±11.65 mm. These changes in the costal cartilage should be considered in biomechanical models of the thorax since the presence, location, and morphology of the calcifications alter the material behavior of the costal cartilage, as well as the structural behavior of the entire rib.