Unstable thorax fixation with bioabsorbable plates and screws. Presentation of some cases1

Rosa, Ana Lilia Nolasco de la; Mosiñoz-Montes, Roberto; Matehuala-García, Jesús; Román-Guzmán, Edgardo; Quero-Sandoval, Fidel; Reyes-Miranda, Alma Lorena

doi:10.1016/j.circen.2015.08.001

Cited by 8 publications

(7 citation statements)

References 14 publications

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“…For multiple rib fractures, methods such as chest band compression external fixation and ventilator-assisted breathing, were used in the past to improve the condition of chest wall collapse and abnormal breathing to some extent. Currently, with the development of medical technology and the emergency of new internal fixation materials (13,14), the treatment of multiple rib fractures by internal rib fixation has become an industry consensus. Internal rib fixation surgery can relieve patients' pain and reduce the related complications, speed the recovery of the patients, and improve the prognosis of patients.…”

Section: Discussionmentioning

confidence: 99%

Application of rib surface positioning ruler combined with volumetric CT measurement technique in endoscopic minimally invasive thoracic wall fixation surgery

et al. 2020

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Section: Discussionmentioning

confidence: 99%

Application of rib surface positioning ruler combined with volumetric CT measurement technique in endoscopic minimally invasive thoracic wall fixation surgery

et al. 2020

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“…Trivial movements are making shear forces which disrupt healing process needing absolute stability necessitating good stabilization [9,10]. This gives plating technique the advantage of providing better and faster sternal healing keeping respiratory functions unaffected with normal chest wall motion avoiding atelectasis and chest infections resulting from severe pain affecting respiration [11,12]. Small number of cases [13][14][15] presented in our work hinder us incapable of giving a strict recommendations yet we think that our results are promising and sharing such results with the international scientific community will help encouraging more surgeons to explore this new technique.…”

Section: Discussionmentioning

confidence: 99%

Sternal reconstruction using locking compression plates (LCP): our experience in Egypt, a case series

Ahmed

Nady

2020

J Cardiothorac Surg

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Background: Sternal fractures are rare accounting for about 3-8% of traumatic chest. There are many lines of treatments for sternal fractures which can be classified as conservative or surgical. Surgical techniques include wire fixation and sternal plating. There are no standardization of indications for each line of management. We explore if sternal reconstruction using locking titanium plates and self-tapping screws provide the patient with the best chance of proper sternal healing avoiding chronic pain and its complications and allow the patient early mobilization and rapid restoring of his normal life at its maximum. Methods: Our inclusion criteria are patients of both gender from 20 to 60 years of age presented with traumatic sternal fracture at any site or pathological fracture due to metastatic or primary tumors infiltrating the sternum. High Associated Injury Scale scores were excluded. Exclusion criteria also included patients younger than 20 years or older than 60 years. Primary outcome is post-operative pain score and is measured using numerical pain scale ranging from zero to 10 where zero means there is no pain at all and ten is the worst imaginable pain ever. Results: Sternal reconstruction using titanium plates has proven to be an efficient method of stabilization with tremendous immediate relief of pain showed by the differences between pre-operative and post-operative pain scale scores in our patients (n = 5) with Median scores being 7 and 1.5 with range being from 7 to 9 and 1 to 3 respectively (p-value = .039). Operative time range between 150 min and 90 min with median of 120 min. Extubation of patients was smooth with no events with median time of extubation being 120 min. From our experience, there were no observed wound complications except at the third patient who suffered a small wound hematoma that was resolved by gentle compressing only and needed no further intervention. Conclusion: We recommend adopting sternal reconstruction using titanium plating systems more readily encouraging even larger clinical trials on the way to a clear guidelines. Plating systems show promising results with least pain, better stability, less complications and rapid, smooth recovery.

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“…In this regard, preformed rib splints (30) have been introduced for fracture fixation ensuring both radial and rotational stability; in addition, they do not present risks of migration (31,32) as an extremity is fixed to the proximal portion of the fractured rib. Finally, an emerging concept for treatment of rib fractures is the use of bioabsorbable materials (33). Finally, Liović et al (34) have reported a new experimental technique using an intramedullary telescoping splint anchored by bone cement.…”

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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Unstable thorax fixation with bioabsorbable plates and screws. Presentation of some cases1

Cited by 8 publications

References 14 publications

Application of rib surface positioning ruler combined with volumetric CT measurement technique in endoscopic minimally invasive thoracic wall fixation surgery

Application of rib surface positioning ruler combined with volumetric CT measurement technique in endoscopic minimally invasive thoracic wall fixation surgery

Sternal reconstruction using locking compression plates (LCP): our experience in Egypt, a case series

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

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