Chest wall stabilization (CWS) in China: current situation and prospect.

Area of Science:

• Trauma Surgery
• Orthopedics
• Thoracic Surgery

Background:

• Rib fracture is the most common chest trauma injury.
• Chest wall stabilization (CWS) is a recognized, safe, and practical therapy for rib fractures in China.
• Despite widespread use (over 30,000 cases in 2 years), CWS in China faces challenges including limited large-scale research, undefined indications, high costs, and lack of standardized professional recognition.

Purpose of the Study:

• To address the limitations in current research on Chest Wall Stabilization (CWS) for rib fractures.
• To improve the understanding and clinical evidence of CWS effectiveness.
• To establish standardized surgical indications and evaluate the technique's impact on patient outcomes.

Main Methods:

• Review of existing CWS research and practices in China.
• Conducting a series of CWS studies at Shanghai Sixth People's Hospital focusing on multi-rib fractures.
• Initiation of a nationwide, multi-center, ambispective cohort study (Evaluation of the effectiveness of surgical fixation of multiple rib fractures) in June 2018.

Main Results:

• Previous CWS research in China has room for improvement.
• Hospital-based studies showed CWS leads to shorter therapeutic time, pain reduction, lower morbidity, and improved lung function.
• Advancements include thoracoscopic-assisted minimally invasive CWS and research into superior biomaterials.

Conclusions:

• Chest wall stabilization (CWS) is a valuable treatment for rib fractures, with demonstrated benefits in pain reduction and functional improvement.
• Further research, particularly large-scale, multi-center randomized controlled trials, is crucial for accurate evaluation and standardization of CWS.
• Ongoing development in surgical techniques and materials promises further advancements in CWS for rib fracture management.