Memory alloy osteosynthesis plate fixation for flail chest injuries：1-year follow-up

Li Tie-bin; Zhang Hai-qing

doi:10.3969/j.issn.2095-4344

Abstract：BACKGROUND:Previously, many authors advocated that the rib fractures can be treated by conservative method. However, with the progress of internal fixation materials science and in-depth study of the rib injury, many authors have begun to recommend that rib fractures should be treated by internal fixation surgery, which may shorten the treatment period and improve patient’s quality of life. But which is the optimal fixation methods, is stil controversial. <br> OBJECTIVE:To summarize the clinical outcomes of the memory aloy osteosynthesis plate fixation for flail chest injuries. <br> METHODS:From May 2008 to May 2011, 50 patients with flail chest were treated with memory aloy osteosynthesis plate fixation in Department of Thoracic Surgery, Qianjiang Central Hospital. There are 39 males and 11 females, the mean age was 42.6 years (range 22-67 years). The flail chest injuries were caused by traffic accidents in 38 cases, by faling from height in 11 cases, and by tire blast injury in 1 case. The mean number of rib fractures was 6.4±4.3 (range 3-11); the mean fracture sites were 11.2±5.6 (range 7-23). There were 25 patients with flail chest at left side, 17 cases at right side, and 8 cases at bilateral sides. The mean time from injury to the surgical time was 3.7±2.2 days (range 2-7 days). The length of postoperative ventilator use, postoperative ICU days, length of hospital stay, peripheral complications, fracture reduction and fracture healing time were observed. The chest wal pains before and after surgery were evaluated with the visual analog scale. <br> RESULTS AND CONCLUSION:Al incisions obtained healing by first intention and al patients were folowed up for 13-22 months. There were no intraoperative complications. Mean postoperative ventilator days were 1.8±0.7 days (range 1-3 days); mean post-operative ICU days were 2.6±1.1 days (range 2-5 days); mean lengths of hospital stay were 14.9±3.1 days (range 12-17 days); the visual analog scale scores was reduced from preoperative 8.1±1.2 points to 4.9±0.9 points at 1 day post-surgery and 3.2±1.1 points at 1 week post-surgery. No cases of hardware failure, hardware prominence, wound infection, or nonunion were observed. Al fractures reached clinical healing, and mean healing time was 3.1±1.2 months (range 2-4 months). The memory aloy osteosynthesis plate fixation is an effective technique for the treatment of flail chest, can provide stability for the injured segments of the chest wal, reduce ventilator time, decrease ventilator-associated complications, reduce deformity, and decrease chronic pain.