Stress profile of infant rib in the setting of child abuse: A finite element parametric study.

The primary goal of this study is to advance our current understanding of infant rib injuries in the setting of child abuse. To this end, we employed finite element model simulations to determine the sensitivity of an infant rib's stress response to varying material properties and under varying degrees of anterior-posterior chest compression. Using high-resolution chest CT images obtained from a 6-day-old infant, we constructed a simplified geometric model consisting of bone and cartilage structures. To simulate the lateral gripping of an infant in child abuse, an anterior-posterior chest compression load was applied to cause increased stresses along the costovertebral articulation, a classic site for inflicted rib fractures. A sensitivity analysis was conducted to quantify the effects of varying Young's modulus and Poisson's ratio of the bones and cartilages. In addition, we varied the amount of anterior-posterior chest displacement to assess the sensitivity of this parameter to the rib's stress profile. We found that varying Young's modulus of the bone and cartilage not only changed the magnitude but also the shape profile of the rib's stress response. In contrast, varying the degree of chest compression only changed the magnitude of the stress response and not the shape profile. We also discovered that by varying Poisson's ratio of the bone and cartilage, no appreciable change was seen in the magnitude or the shape profile of the rib's stress response. Finite element modeling shows promise as a tool to elucidate the mechanisms of rib fractures in abused infants.