ISSN: 1859 - 2872
Application of surgical rib fixation with plates and screws for the treatment of flail chest caused by blunt thoracic trauma
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Abstract
Objective: To determine the role of computed tomography scans of the chest in the diagnosis of mobile flail chest and, when feasible, to evaluate the effectiveness of surgical internal fixation of rib fractures with plate fixation in patients with severe chest wall injuries and mobile flail chest. Subject and method: This case series describes all patients diagnosed with severe chest wall injury and flail chest who underwent surgical plate fixation from January 2020 to December 2023 at Thai Binh Provincial General Hospital. Demographic data are presented as mean ± standard deviation and compared using t-tests and ANOVA. Categorical data are presented as percentages and compared using Chi-square tests. Result: 23 patients were diagnosed with severe chest wall injury and mobile flail chest. The average age was 57.4 ± 12.4 years; male/female ratio was 11/1. The primary cause of chest wall injury was traffic accidents (56.5%). 143 fractured ribs were identified on computed tomography scans, and 108 fractured ribs were identified on chest X-rays. The average number of fractured ribs was 6.8 ± 3.0. The number of ribs with paradoxical movement was 3.9 ± 1.2. The number of patients admitted to the ICU post-surgery was 15/23 (65.2%). Postoperative comlications included pneumonia (13%) and respiratory failure (13%). The average length of hospital stay post-surgery was 11.8 ± 4.6 days. No instances of wound dehiscence, infection of the metal plate, or mortality were observed during the hospital stay. Conclusion: Computed tomography of the chest with 3D reconstruction of the rib cage is performed to evaluate the status of rib fractures and associated thoracic injuries. It also assists surgeons in accurately determining the surgical approach and the number of ribs requiring fixation. Surgical internal fixation of rib fractures with plate fixation is a safe and feasible surgical procedure, currently performed at provincial hospitals.
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References
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