Li Zhi-cheng, Wang Chang-tao, Xue Bing, Lü Yi-feng, Xiong Jian, Wang Dong-dong

Department of Thoracic Surgery, Nanhui Branch of Huashan Hospital, Fudan University, Shanghai  201300, China

Li Zhi-cheng★, Master, Attending physician, Lecturer, Department of Thoracic Surgery, Nanhui Branch of Huashan Hospital, Fudan University, Shanghai  201300, China
zcli_renji@hotmail.
com
Abstract
BACKGROUND: The management of rib fracture varies greatly due to lack of consensus regarding if internal fixation of fractured ribs is needed, who and which methods to achieve stability.
OBJECTIVE: To retrospectively analyze the necessity and feasibility of internal fixation of rib plate implanted into 39 patients with blunt chest trauma last two years.
METHODS: A total of 39 patients suffering from sustained blunt chest trauma, including 32 males and 7 females, averagely aging (47.8±13.8) years, were treated with operative chest wall fixation. There were 4 patients with flail chest without pulmonary contusion, 10 patients with flail chest and pulmonary contusion, 15 patients without flail chest and pulmonary contusion, and 10 patients without flail chest but with pulmonary contusion. According to different clinical statuses, patients were either treated with conservative therapy at admission and secondary operative stabilization or need urgent surgery to manage intrathoracic injuries and underwent surgical stabilization of chest wall with rib plates.
RESULTS AND CONCLUSION: Satisfactory effects were aquired in all patients with rib fracture using rib plates, including stabilization in chest wall, rectification of collapsed chest walls and thoracic deformity. However, a 68-year-old patient died for pneumonia, sepsis, and then septic shock at 26 days after operation. Clinical results in other patients were excellent after surgical stabilization of chest wall. Postoperative chest X-rays or chest CT demonstrated favorable reduction, no migration or dislocation, general symmetry in two side thorax. Compared with preoperation, collapsed chest walls and thoracic deformity were vanished and retrieved to normal on the whole. Patients with rib fractures, no matter with or without flail chest or pulmonary contusion, treated with operative chest wall fixation with rib plates are practicable, and will have a satisfactory effect.

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