不安定肋骨骨折術後の変位遅延リスクと生体力学的解析

Rib fractures, particularly multiple fractures, are common in patients with chest trauma and can lead to complications and an increased risk of mortality. Surgical treatment can improve patient prognosis, but fixation of nondisplaced fractures is often overlooked, and nonfixed nondisplaced fractures may undergo delayed displacement postsurgery. This study explored the risk of delayed displacement of nonfixed fractures during surgical treatment and its biomechanical mechanisms.

A total of 105 patients with multiple rib fractures were included. CT scans were used to assess fracture displacement, and finite element analysis was applied to simulate the effect of thoracic movement on displacement.

Postoperatively, 56.1% of patients experienced delayed displacement, with posterior rib fractures being the most prone to displacement. Finite element analysis revealed that the posterior ribs exhibited the most significant displacement at the end of inspiration. Statistical analysis indicated that posterior rib fractures were associated with delayed displacement (OR = 0.225, p = 0.025).

Nonfixed, nondisplaced rib fractures are at high risk of delayed displacement postsurgery, particularly in the posterior rib region. Attention should be focused on posterior rib fractures to reduce delayed displacement and improve patient prognosis.