Comparison of minimally invasive surgery for non-flail chest rib fractures: a prospective cohort study

Abstract

Background: To evaluate therapeutic efficacy of minimally invasive and small incision surgery [minimally invasive surgery (MIS)] in patients with non-flail chest rib fractures through a prospective cohort study.Methods: This study included 98 patients with non-flail chest rib fractures (≥3 displaced fractures) and 66 patients undergoing MIS served as the experimental group and 32 patients receiving conservative treatment served as the matched control group. Pain index and indicators of pulmonary function [vital capacity (VC); forced expiratory volume in one second (FEV1); peak expiratory flow (PEF)] for the two groups were assessed and compared at the time of admission and before discharge. In addition, duration of pain, time required for the patient to regain the ability to perform daily self-care, mental labor, and moderate-to-severe physical labor, and duration of chest discomfort were measured during long-term follow-up and compared between the two groups.Results: There were also no significant differences (P>0.05) in pain index (8 vs. 8) or indicators of pulmonary function (VC: 31.0% vs. 26.5%; FEV1: 29.9% vs. 26.7%; PEF: 15.2% vs. 12.0%) were found between the MIS and conservative treatment groups at the time of admission; while pain index (3 vs. 6), VC (42.1% vs. 35.3%), and FEV1 (44.2% vs. 35.9%) were significantly different between the two groups (P<0.05) but not in PEF (21.2% vs. 19.6%) before discharge. Long-term follow-up showed that duration of pain, time required for the patient to regain the ability to engage in daily self-care, mental labor, and moderate-tosevere physical labor, and duration of chest discomfort in the MIS group were significantly more improved than in the conservative treatment group (P<0.05).Conclusions: MIS was a simple and safe treatment that significantly relieved chest pain and rapidly restored pulmonary function and improved the long-term quality of life of patients with non-flail chest rib fractures of ≥3 ribs with displacement.

Surgical Treatment of Costal Cartilage Fractures With Titanium Plate Internal Fixation

“…It has been proved in our previous studies that the fractures of multiple continuous ribs may cause severe impairment of pulmonary function (PF). [10][11]Meanwhile, it has also been proved that the internal xation of rib fracture can signi cantly improve the impaired PF in the acute phase, which has also been con rmed by a great number of studies [12][13][14]. In this study, we con rmed that costal cartilage fractures may also cause the impaired integrity of thoracic cage.…”

Surgical treatment of costal cartilage fractures with titanium plate internal fixation

“…It has been proved in our previous studies that the fractures of multiple continuous ribs may cause severe impairment of pulmonary function (PF) [ 9 , 10 ]. Meanwhile, it has also been proved that the internal fixation of rib fracture can significantly improve the impaired PF in the acute phase, which has also been confirmed by a great number of studies [ 11 – 13 ]. In this study, we confirmed that costal cartilage fractures may also cause the impaired integrity of thoracic cage [ 14 ].…”

Does surgical fixation improve pain and quality of life in patients with non-flail rib fractures? A best evidence topic review

“…Li et al [ 5 ] conducted a prospective cohort study involving 98 patients with non-flail fractures of at least 3 consecutive ribs, with 66 undergoing surgical fixation and 32 matched controls receiving conservative treatment. Surgically treated patients had significantly lower Visual Analogue Scale pain indices at discharge, and significantly shorter duration of pain.…”