Operative management of flail chest with anatomical locking plates (MatrixRib)

Ramponi, Fabio; Meredith, Graham; Bendinelli, Cino; Söderlund, Tim

doi:10.1111/j.1445-2197.2012.06159.x

Cited by 4 publications

(2 citation statements)

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“…The experiences by Judet (22) and by Sanches-Lloret et al (23) are just historical notes. The modern evolution of cortical fixation for fractured ribs has led to the development of anatomically shaped plates -U-plate (24), ana- tomical rib plates (3,25,26). Nowadays, these latters can also be fixed via a minimally invasive technique (minimally invasive plate osteosynthesis or MIPO) (27).…”

Section: Discussionmentioning

confidence: 99%

Crossed Kirschner’s wires for the treatment of anterior flail chest: an extracortical rib fixation

Mucilli

Camplese

Cipollone

et al. 2016

Journal of Emergency Practice and Trauma

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Objective: Thoracic trauma may be a life-threatening condition. Flail chest is a severe chest injury with high mortality rates. Surgery is not frequently performed and, in Literature, data are controversial. The authors report their experience in the treatment of flail chest by an extracortical internal-external stabilization technique with Kirshner's wires (K-wires). Methods: From 2010 to 2015, 137 trauma patients (109 males and 28 females) with an average age of 58.89 ±19.74 years were observed. Seventeen (12.41%) patients presented a flail chest and of these, 13 (9.49%) with an anterior one. All flail chest patients underwent early chest wall surgical stabilization (within 48 hours from the injury). Results: In the general population, an overall morbidity of 21.9% (n = 30 of 137) and a 30-day mortality rate of 5.1% (n = 7 of 137) were observed. By clustering the population according to the treatment (medical or interventional vs surgical), significant statistically differences between the two cohorts were found in morbidity (12.65% vs. 34.48%, P = 0.002) and mortality rates (1.28% vs. 10.34%, P = 0.017). In patients undergoing chest wall surgical stabilization, with an average Injury Severity Score of 28.3 ± 5.2 and Abbreviated Injury Score (AIS) of 8.4 ± 1.7, an overall morbidity rate of 52.9% (n = 9) and a mortality rate of 17.6% (n = 3) were found. Post-surgical device removal, in local anesthesia or mild sedation, was performed 42.8 ± 2.9 days after chest wall stabilization and no cases of wound infection, dislodgment of the wires or osteosynthesis failure were reported. Moreover, in these patients, an early postoperative improvement in pulmonary ventilation (ΔpaO 2 and ΔpCO 2 : +9.49 and -5.05, respectively) was reported. Conclusion: Surgical indication for the treatment of flail chest remains controversial and debated both due to an inadequate training and the absence of comparative prospective studies between various strategies. Our technique for the surgical treatment of the anterior flail chest seems to be anachronistic, but the aspects described, both in terms of technical features and of outcome and benefits (health, economic), allow to evaluate the effectiveness of this approach.

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Section: Discussionmentioning

confidence: 99%

Crossed Kirschner’s wires for the treatment of anterior flail chest: an extracortical rib fixation

Mucilli

Camplese

Cipollone

et al. 2016

Journal of Emergency Practice and Trauma

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“…The needs must lead the shaping of plates, in order to adapt to the individual patient according to the ribs involved. There are two fundamental features of these devices: (I) corrosion resistance and elasticity, with coefficient of friction minimization and not interference with the physiological movement of the ribs, once the stiffness of the rib cage obtained; (II) quick and easy application method that allows a drastic reduction in surgical time (15,16). Some authors (17)(18)(19) compared outcomes between surgical stabilization with titanium plates and conservative management of trauma.…”

Section: Titanium Plates and Screwsmentioning

confidence: 99%

Reconstructive options of the chest wall after trauma: a narrative review

Divisi¹,

Vico²,

Zaccagna³

et al. 2023

AME Surg J

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Background and Objective: Trauma remains the third leading cause of death in the world and the involvement of the chest with multiple rib fractures is an aggravating factor in the patient's outcomes. We perform a review of the literature, examining the current surgical options, in order to evaluate the most effective method of restoring quickly the excellent general conditions. Methods:We carried out research of the papers in literature by performing a search on the MEDLINE database through PubMed including works from the past 10 years using the following criteria: "chest trauma AND chest wall". A total of 1,385 results were obtained and 1,108 articles were identified after the duplicates were removed. Only 214 were rated relevant after reading the full text.

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