Bridge fixation provides consistent implant stability across surgical techniques: A multicenter study
Luzia Toselli1, Gastón Bellia-Munzón1, Carla Vega2
1Clínica Mi Pectus, Vidal 4672, Ciudad Autónoma de Buenos Aires, Argentina; Hospital General de Niños Pedro de Elizalde, Pediatric Surgery Department, Av. Montes de Oca 40, Ciudad Autónoma de Buenos Aires, Argentina.
Background/Purpose:
Bar rotation remains a relevant complication following minimally invasive repair of pectus excavatum (MIRPE), with potential need for reoperation and risk of severe intrathoracic injury. Bridge fixation has been proposed as a stabilization strategy to prevent implant rotation; however, evidence supporting its effectiveness remains limited. This study aimed to evaluate the stability of bridge fixation in a large multicenter cohort.
Methods:
A retrospective multicenter study was conducted including patients undergoing chest wall repair with intrathoracic implants stabilized using bilateral lateral bridges across five centers in Buenos Aires, Argentina, between November 2015 and November 2025. Demographic characteristics, surgical technique, implant configuration, use of cryoanalgesia, postoperative length of stay, complications, and implant removal were collected. The primary outcome was reoperation due to implant rotation.
Results:
A total of 1821 intrathoracic implants were placed in 710 patients. Median age was 15.0 years (IQR 14.0; 17.0; range 9-52), with 174 patients (24.6%) older than 17 years. Most procedures were MIRPE (92.5%), followed by the sandwich technique (3.9%) and hybrid techniques (3.5%). Two bars were used in 44.4% of patients and three bars in 54.9%. Crossed bars were used in 31.0% of cases, and cryoanalgesia was used in 68.6% of patients. Implant removal was performed in 52.0% of patients at a median of 24.0 months (IQR 23.0; 25.0). Overall, postoperative complications requiring reoperations occurred in 6.1% of patients. No implant rotation requiring reoperation was observed among the 1821 implants during the study period.
Conclusions:
In this large multicenter series, bridge fixation was associated with complete prevention of implant rotation requiring reoperation across a wide range of surgical techniques, implant configurations, and patient characteristics. These findings support the reliability of the bridge technique to prevent implant rotation.
Type Of Study:
Treatment study.
Level Of Evidence:
IV.
More Related Videos
05:34A Mini-Invasive Internal Fixation Technique for Studying Immobilization-Induced Knee Flexion Contracture in Rats
Published on: May 20, 2019
04:19Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
Published on: November 8, 2024