Abstract
It is now common to perform the Nuss procedure as a surgical treatment for pectus excavatum. As several types of detailed surgical methods exist as part of the Nuss procedure, studies are currently being conducted to verify their relative superiority via computerized biomechanical methods. However, no studies have considered the influence of sternoclavicular joints on the simulations of the Nuss procedure. Accordingly, this study aims to demonstrate the influence of these joints by comparing the clinical data with the finite element analysis data. Scenarios were set by classifying the movement of the joints based on the constraints of translation and rotation in the coordinate plane. The analyses were performed by applying the set scenarios to the constructed finite element model of a chest wall. The sternal displacement, Haller index, and equivalent stress were obtained from the analysis, and the data were compared with the data of the postoperative patient. When the translation of the anterior direction on the chest wall was constrained, the result obtained thereof was found to be similar to those obtained in the actual surgery. It is suggested that more accurate results can be obtained if the influence of the sternoclavicular joints is considered.
Highlights
It is common to perform the Nuss procedure as a surgical treatment for pectus excavatum
This computerized biomechanical verification of the Nuss procedure is performed by comparing the actual surgery data with the output mechanical values according to the predicted form after inserting the pectus bar into the developed chest wall of the finite element (FE) model[11,12]
The displacement scenario was determined using a high similarity through comparison with postoperative image data of an actual patient
Summary
It is common to perform the Nuss procedure as a surgical treatment for pectus excavatum. Additional studies have recently been conducted to predict the form of the postoperative chest wall using a finite element (FE) analysis[8,9,10] This computerized biomechanical verification of the Nuss procedure is performed by comparing the actual surgery data with the output mechanical values according to the predicted form after inserting the pectus bar into the developed chest wall of the FE model[11,12]. Studies performed to verify the Nuss procedure via the FE method do not consider the resistance of these SC joints This is a significant factor to consider when examining the mechanical behavior of the chest wall, and it is clinically recognized that this influences the elevation of the sternum. By verifying the influence of the SC joints, we will be able to conduct a more accurate evaluation of the Nuss procedure
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