[Surgical stabilization of thoracic wall fractures]

Area of Science:

• Trauma Surgery
• Thoracic Surgery
• Orthopedic Surgery

Context:

• Chest wall injuries are often managed conservatively, with surgical intervention being infrequent (5.19% of inpatient cases).
• Indications for surgical stabilization include concurrent intrathoracic injury, failure of conservative treatment for respiratory insufficiency, and severe chest wall deformities.
• The study focuses on a small cohort of 12 patients with severe chest wall trauma, highlighting the complexity and severity of associated injuries.

Purpose:

• To report the experience and outcomes of treating chest wall injuries with stable internal fixation using rib plates.
• To evaluate the effectiveness of surgical stabilization in achieving pain-free spontaneous ventilation and reducing mechanical ventilation duration.
• To assess complications and late outcomes associated with surgical intervention for severe chest wall trauma.

Summary:

• Twelve patients with severe chest wall injuries underwent surgical stabilization with rib plates.
• The mean age was 58 years, with high Injury Severity Scores (mean PTS 28.5), indicating significant associated trauma.
• Surgical fixation allowed for pain-free spontaneous ventilation in 50% of patients within 1-5 days post-operation, with low rates of procedure-specific complications.

Impact:

• Surgical stabilization of severe chest wall injuries can facilitate early liberation from mechanical ventilation and improve patient comfort.
• Despite the severity of trauma, rib plate fixation demonstrates a favorable safety profile with minimal early complications.
• This approach offers a viable option for selected patients with complex chest wall disruptions, potentially improving recovery trajectories.