• Surgical stabilization of the chest: experience and perspectives
en To content Full text of article

Surgical stabilization of the chest: experience and perspectives

PAEDIATRIC SURGERY.UKRAINE.2019.2(63):18-22; DOI 10.15574/PS.2019.63.18

Pertsov V. I., Tielushko Y. V., Barchuk A. I., Bondar A. V., Guz S. G., Naumenko V. M., Savchenko S. I., Troyan G. S., Yakusheva N. S.
Zaporizhzhya State Medical University, Ukraine
MI «City Clinical Hospital of Emergency and Emergency Medical Care of Zaporizhzhya», Ukraine

The article gives an overview of the long-term use of osteosynthesis of ribs by wires and plates for the surgical stabilization of the chest wall during injury. It has been established that the use of this method has the features of a complex approach; the main term of application is delayed (89.1% of cases). It is possible to achieve good direct results in 91.9%; the level of postoperative complications is 6.8%. Stabilization of rib fractures is an absolutely necessary procedure for rendering assistance to victims of fractures of the ribs and sternum. The choice of the method of surgical stabilization depends on the patient’s condition, the experience of the clinic and/or surgeon, the source of funding.

Key words: blunt chest trauma, rib fractures, surgical treatment.

REFERENCES

1. Wagner EA. (1969). Closed injury of chest of peacetime. Moscow: Medicine: 300.

2. Glomcher FS, Fomin PD, Pedachenko EG et al. (2012). Polytrauma: surgery, traumatology, anesthesiology, intensive care: a manual. Kyiv: VSI Medicine: 735.

3. Melnyk VM, Opanasenko MS, Tereshkovich OV et al. (2015). Diagnosis and treatment of chest trauma: a methodical manual for doctors. Kyiv: 27.

4. Panasenko SI, Kovalchuk SB, Guriev SO et al. (2017). Biomechanical characteristics of individual methods of osteosynthesis of ribs. Trawma. 18; 2: 122–127. https://doi.org/10.22141/1608-1706.2.18.2017.102570

5. Pertsov VI, Telushko YaV. (2008). The method of surgical treatment of numerous and segmental fractures of ribs: the register. No. 336/29/08. Register of sectoral innovations. 28–29: 222.

6. Avery EE, March ET, Benson DW. (1956). Critically crushed chest: a new method of treatment with continuous mechanical hyperventilation to produce alkalotic apnea and internal pneumatiс stabilization. J Thoracic Surg. 32: 291–311.

7. Bemelman M, Blokhuis TJ, Leenen LPH. (2010). Historic overview of treatment techniques for rib fractures and flail chest. Eur J Emerg Surg. 36(5): 407–415. https://doi.org/10.1007/s00068-010-0046-5; PMid:21841952 PMCid:PMC3150827

8. Burstrom K, Sun S, Gerdtham UG еt al. (2014). Swedish experience-based value sets for EQ-5D health states. Qual Life Res. 23;2: 431–442. https://doi.org/10.1007/s11136-013-0496-4; PMid:23975375 PMCid:PMC3967073

9. Caragounis E, Olsen MF, Pazooki D еt al. (2016). Surgical treatment of multiple rib fractures and flail chest in trauma: a one-year follow-up study. World Journal of Emergency Surgery. 11: 27–33. https://doi.org/10.1186/s13017-016-0085-2; PMid:27307787 PMCid:PMC4908779

10. Сohen EA. (1955). Treatment of the flail chest by towel clip traction. Am J Surg. 90: 517–521. https://doi.org/10.1016/0002-9610(55)90790-X

11. De Buck F, Devroe S, Missant C еt al. (2012). Regional anesthesia outside the operating room: indications and techniques. Curr Opin Anaesthesiol. 25; 4: 501–507. https://doi.org/10.1097/ACO.0b013e3283556f58; PMid:22673788

12. Fabricant L, Ham B, Mullins R еt al. (2013). Prolonged pain and disability are common after rib fractures. Am J Surg. 205; 5: 511–515. https://doi.org/10.1016/j.amjsurg.2012.12.007; PMid:23592156

13. Granetzny A, Abd M, Emam E, Shalaby A, Boseila A. (2005). Surgical versus conservative treatment of flail chest. Evaluation of the pulmonary status. Interact. Cardiovasc. Thorac. Surg. 4; 6: 583–587. https://doi.org/10.1510/icvts.2005.111807; PMid:17670487

14. Hudson TR, Mc Elvenny RT, Head JR. (1954). Chest wall stabilization by softtissue traction: a new method. JAMA. 156: 768–769. https://doi.org/10.1001/jama.1954.02950080016007; PMid:13201399

15. Kyriss T, Lenz U, Friedel G. (2016). Functional Outcome after Chest Wall Stabilisation. Zentralbl Chir. 141; 1: 6–11. https://doi.org/10.1055/s-0042-111327; PMid:27607891

16. Marasco SF, Davies AR, Cooper J et al. (2013). Prospective randomized controlled trial of operative rib fixation in traumatic flail chest. Am Coll Surg. 216; 5: 924–932. https://doi.org/10.1016/j.jamcollsurg.2012.12.024; PMid:23415550

17. Molnar TF. Surgical Management of Chest Wall Trauma. (2010). Thoracic Surgery Clinic. 20; 4: 475–485. https://doi.org/10.1016/j.thorsurg.2010.07.004; PMid:20974431

Article received: Jan 23, 2019. Accepted for publication: Jun 10, 2019.