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Restoring thoracic stability with rigid titanium rib reconstruction after radical forequarter and upper chest wall
Ahmad D Rifa'i1, Hashfi F Raz1, Muhammad H Duha1
1Department of Thoracic, Cardiac and Vascular Surgery, University of North Sumatra, RSUP H. Adam Malik, Medan, Indonesia.
Abstract:
Extensive anterior chest wall involvement in chondrosarcoma presents major reconstructive challenges following radical oncologic resection. A 55-year-old man with cT4N0M0 chondrosarcoma involving the right shoulder girdle, ribs 1-4, and right upper lobe underwent en bloc extended forequarter amputation, multilevel rib resection, and right upper lobe segmentectomy. Chest wall reconstruction was performed using a titanium-based RibLoc plating system with vascularized soft-tissue flap coverage. Postoperatively, chest wall stability was preserved without paradoxical motion, and radiographs confirmed appropriate implant positioning. The patient was successfully weaned from mechanical ventilation on postoperative day two and transferred from the intensive care unit on day three without major complications. Rigid titanium rib fixation provided effective structural restoration and favorable early postoperative outcomes following extensive anterior chest wall resection for advanced chondrosarcoma.