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Results of the rib fractures stablisation by locked plate fixation at Viet Duc University Hospital
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Abstract
Overview: Fractures of the ribs are a major lesion of chest trauma, mostly with conservative treatment. In case of multiple fractures, multiple displacement fractures, surgical fixation of the broken rib is indicated. There are many surgical techniques, of which fixing with a blocked plate is the most common. Viet Duc Hospital has started to apply this method since 2018. The study aims to evaluate the initial results of the method. Method: A prospective cross-sectional descriptive study in patients with complex chest trauma, indicated and performed surgery to fix the rib fracture with a RibFixBlu type blocked plate, and early evaluation of the ealier results, from January 2018 to March 2020. Results: Including 22 patients, aged 45.3 ± 13.1 (23–68), male take 68.2%. Quite a lot of serious chest injuries: chest fail 40.9% (9 cases), chest deformity 54.5% (12 cases). The number of fractured ribs detected on CT scan was 8.86 ± 3.53 ribs / 1 patient (6–19), which was significantly higher (p <0.05) than with a normal chest radiograph, but equivalent for 4th-6th ribs. The index of rib fractures (RFS) is mostly at the level of 3-4. Average surgery time is 98.5 ± 12.5 minutes (82 - 130). The average number of rib fixation was 3.1 ± 1.03, up to 6 ribs for patients with 19 fractures, most in the lateral 4th-7th ribs, of which 100% was in the 5th rib and 81.8% in 6th rib. No significant complications during surgery. The postoperative analgesic effect is evident in most of the patients. Early results: 86.4% uncomplicated cure (19 cases), 2 cases of atelectasis and 1 case of pneumonia; length of stay in hospital 12.2 ± 4.9 days (8-25); There were no deaths in the study group. Conclusion: Rib’s fixation with a blocked plate is a safe and effective method. Surgical indications are carefully selected and reasonable based on clinical and subclinical symptoms. There is a need for comparative studies with the conservative treatment group, as well as evaluating the long-term effectiveness of surgery.
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Keywords
rib fixation, blocked plate fixation, Viet Duc
References
2 Vyhnánek F, Jirava D, Očadlík M, Škrabalová D. Surgical Stabilisation of Flail Chest Injury: Indications, Technique and Results. Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca. 2015;82(4):303-307.
3 Althausen PL, Shannon S, Watts C, et al. Early surgical stabilization of flail chest with locked plate fixation. Journal of orthopaedic trauma. Nov 2011;25(11):641-647.
4 Marasco SF, Davies AR, Cooper J, et al. Prospective randomized controlled trial of operative rib fixation in traumatic flail chest. Journal of the American College of Surgeons. May 2013;216(5):924-932.
5 Caragounis EC, Fagevik Olsén M, Pazooki D, Granhed H. Surgical treatment of multiple rib fractures and flail chest in trauma: a one-year follow-up study. World journal of emergency surgery : WJES. 2016;11:27.
6 Kocher GJ, Sharafi S, Azenha LF, Schmid RA. Chest wall stabilization in ventilator-dependent traumatic flail chest patients: who benefits?. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. Apr 1 2017;51(4):696-701.
7 de Moya M, Nirula R, Biffl W. Rib fixation: Who, What, When?. Trauma surgery & acute care open. 2017;2(1):e000059.
8 Campbell N, Conaglen P, Martin K, Antippa P. Surgical stabilization of rib fractures using Inion OTPS wraps--techniques and quality of life follow-up. The Journal of trauma. Sep 2009;67(3):596-601.
9 Cameron Gettel DM. Rib Fracture Repair: Assessing the Effects of Various Levels of Fixation on Stability of a Flail Chest Segment. AMSRJ. 2014;1.
10 Leinicke JA, Elmore L, Freeman BD, Colditz GA. Operative management of rib fractures in the setting of flail chest: a systematic review and meta-analysis. Annals of surgery. Dec 2013;258(6):914-921.