ĐẶC ĐIỂM LÂM SÀNG VÀ CHỈ ĐỊNH PHẪU THUẬT KẾT HỢP XƯƠNG SƯỜN BẰNG NẸP VÍT ĐIỀU TRỊ CHẤN THƯƠNG NGỰC TẠI BỆNH VIỆN HỮU NGHỊ VIỆT ĐỨC

Abstract

Purpose: To evaluate the clinical characteristics, operative indications, and timing of rib fixation surgery using plates and screws in the treatment of chest trauma at Viet Duc University Hospital during the period of 2018 to 2023. Methods: A retrospective descriptive study was conducted on patients with chest trauma who underwent rib fixation surgery using plates and screws at the Cardiovascular and Thoracic Center, Viet Duc University Hospital, from January 2018 to August 2023. Results: A total of 44 patients met the inclusion criteria. The mean age was 48.09 ± 13.45 years, and 61.4% were male. The main cause of injury was traffic accidents (77.3%). Chest pain was present in 95.5% of patients, 26(59.1%) required supplemental oxygen, and 03(6.8%) required endotracheal intubation. Decreased vesicular resonance were observed in 97.7% of patients, and 25% had clinical signs of flail chest. The average number of rib fractures on chest X-ray was 6.27±2.86 and on chest CT was 8.23±3.82; 31.8% had hemothorax, and 68.2% had hemopneumothorax; 22(50%) had lung contusion, 01(2.3%) had tracheal injury, and 02(4.5%) had major vascular injuries. Surgical indications included flail chest in 38.6% of patients and ≥3 displaced rib fractures in 59.1%. The mean time to surgery was 5.77 ± 4.02 days. There was no significant difference in age (p=0.083) and gender ratio (p=0.907) between early and late surgery groups. There was a correlation between the severity of injury and the choice of surgical timing (p=0.023). Conclusion: Rib fixation operation using plates and screws for the treatment of rib fracture in chest trauma is feasible and gives good results. The main operative indications include flail chest and multiple displaced rib fractures (above 3 ribs), severe pain. Preoperative patient assessment is relevant to the selection of appropriate operative timing.