RIB FIXATION SURGERY IN FLAIT CHEST DUE TO BLUNT CHEST TRAUMA

Thanh Việt Phạm 1, Viết Đăng Quang Nguyễn1,, Phú Thi Châu 1
1 Cho Ray hospital

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Abstract

Background: Rib fixation surgery in the treatment of flait chest due to blunt chest trauma has been reported in many parts of the world. In Vietnam, there are also reviews on rib fixation surgery in general, but there are still few documents focusing on surgical results of traumatic rib fracture with flait chest. Methods: A retrospective description of 40 closed chest trauma patients with flait chest who underwent surgery to fix broken ribs with titanium plates and screws at the Thoracic Surgery Department of Cho Ray Hospital from January 2018 to February. year 2022. Results: The majority of patients with traumatic rib fractures are male, accounting for 75%. The mean age was 49.8 ± 11.3 years old. The patient's mean ISS score was 23.4 ± 5.8, which was classified as multiple major trauma. On chest CT scan with rib reconstruction, the total number of broken ribs is 400. The ratio of the number of fixed rib fractures to the number of displaced sites per body bone is: 135/200 (67.5%). The total number of fractures fixed on ribs number 4,5,6,7th is 118, accounting for 87.4%. Most patients underwent surgery to fix the ribs using 3 or 4 plates, accounting for 82.5%. 13 patients had to stay in the intensive care unit after surgery, accounting for 32.5%. The mean time of pleural drainage was 3.6 ± 2.1 days. Complications of pneumonia after surgery accounted for 15.0%. There were no cases of surgical wound infection, pleural cavity infection or metal splint displacement. Recorded 01 case died due to multiple trauma. The number of displaced positions of more than one bone body recorded on chest Ct scan and the number of rib plating used were positively correlated with each other, r=0.829 (p<0.01). Conclusion: Rib fixation surgery in the treatment of flait chest due to blunt chest trauma showed safety and high efficiency. Chest CT scan has a diagnostic role, guiding the selection of fracture locations to be fixed.

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References

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