A novel in silico Nuss procedure for pectus excavatum patients

The purpose of this study is to suggest a novel in silico Nuss procedure that can predict the results of chest wall deformity correction. Three-dimensional (3D) geometric and finite element model of the chest wall were built from the 15-year-old male adolescent patient's computed tomography (CT) image with pectus excavatum of the mild deformity. A simulation of anterior translating the metal bar (T) and a simulation of maintaining equilibrium after 180-degree rotation (RE) were performed respectively. A RE simulation using the chest wall finite element model with intercostal muscles (REM) was also performed. Finally, the quantitative results of each in silico Nuss procedure were compared with those of postoperative patient. Furthermore, various mechanical indicators were compared between simulations. This confirmed that the REM simulation results were most similar to the actual patient's results. Through two clinical indicators that can be compared with postoperative patient and mechanical indicators, the authors consider that the REM of silico Nuss procedure proposed in this study is best simulated the actual surgery.

Automated summary

The purpose of this study is to propose a new in silico Nuss procedure that can predict the outcomes of chest wall deformity correction. A 3D geometric and finite element model of the chest wall was built from a CT image of a 15-year-old male patient with mild pectus excavatum. Simulations of anterior translating the metal bar and maintaining equilibrium after a 180-degree rotation were performed. A simulation with the chest wall finite element model and intercostal muscles was also conducted. The results of the REM simulation were found to be most similar to the actual patient's outcomes. By comparing clinical and mechanical indicators with postoperative patients, the authors conclude that the REM simulation of the in silico Nuss procedure proposed in this study best simulates the actual surgery.