Video-assisted thoracoscopic-guided open reduction and plate fixation of ribs combined with closed thoracic drainage for rib fractures complicated by hemopneumothorax:an efficacy observation
Han Yunyun
Wang Meijia
Jiang Zhibiao
Yang Zhongjie
Song Jiawen
Zhang Shan
Zhang Ling
Abstract：Objective To observe the clinical efficacy of video-assisted thoracoscopic-guided open reduction and plate fixation of ribs combined with closed thoracic drainage in the treatment of rib fractures complicated by hemopneumothorax,provi-ding a reference for clinical decision-making.Methods From July 2020 to December 2024,126 patients with rib fractures complicated by hemopneumothorax treated at our hospital were enrolled and randomly assigned by drawing lots to an obser-vation group(n=63;video-assisted thoracoscopic-guided open reduction and plate fixation of ribs combined with closed tho-racic drainage)or a control group(n=63;conventional transthoracic internal fixation).Length of hospital stay,time to in-dependent ambulation,and time to chest pain relief were compared between groups.At 1 month postoperatively,clinical outcomes(fracture alignment rate,lung re-expansion rate,incision healing rate)were compared.Arterial blood gas indices were compared preoperatively and at 8 hours postoperatively.Postoperative complications within 1 month were recorded and compared.Results The observation group had significantly shorter length of hospital stay,earlier time to independent am-bulation,and shorter time to chest pain relief than the control group(P＜0.05).The observation group showed significant-ly higher fracture alignment rate,lung re-expansion rate,and incision healing rate than the control group(P＜0.05).At 8 hours postoperatively,the observation group had higher arterial partial pressure of oxygen(PaO2),arterial oxygen satura-tion(SaO2)and oxygenation index,ratio of PaO2 to fractional inspired oxygen(PaO2/FiO2),and lower arterial partial pressure of carbon dioxide(PaCO2)as compared with the control group;the differences were statistically significant(P＜0.05).At 1 month postoperatively,the overall incidence of complications in the observation group was significantly lower than in the control group(P＜0.05).Conclusion Video-assisted thoracoscopic-guided open reduction and plate fixation of ribs combined with closed thoracic drainage facilitates postoperative recovery in patients with rib fractures complicated by he-mopneumothorax,strengthens arterial blood gas indices,and reduces the risk of complications,with favorable clinical effi-cacy.
Keywords：ThoracoscopeRibFractureHemopneumothoraxPlateClosed drainage
Publication Date：2025-11-20
Online Publishing Date：2026-03-13(First online date of this platform, not the publication date of the document)
Pages：6( 102-107 )