Kết quả phẫu thuật kết hợp xương sườn gãy bằng tấm nẹp vít tại Bệnh viện Hữu nghị Việt Đức

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 4^th-6^th 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 4^th-7^th ribs, of which 100% was in the 5^th rib and 81.8% in 6^th 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.