Flail chest in polytraumatized patients: surgical fixation using Stracos reduces ventilator time and hospital stay.

Abstract

OBJECTIVES:

Conservative management of patients with flail chest is the treatment of choice. Rib fracture repair is technically challenging; however, with the advent of specially designed molding titanium clips, surgical management has been simplified. Surgical stabilization has been used with good outcomes. We are reporting on our institutional matched-case-control study.

METHODS:

Between April 2010 and April 2011, ten polytraumatized patients undergoing rib stabilization for flail chest were matched 1 : 1 to 10 control patients by age ±10 years, sex, neurological or vertebral trauma, abdominal injury, and arm and leg fractures. Surgery was realized in the first 48 hours.

RESULTS:

There were no significant differences between groups for matched data and prognostic scores: injury severity score, revised trauma score, and trauma injury severity score. Ventilator time (142 ± 224 versus 74 ± 125 hours, P = 0.026) and overall hospital stay (142 ± 224 versus 74 ± 125 hours, P = 0.026) were significantly lower for the surgical group after adjustment on prognostic scores. There was a trend towards shorter ICU stay for operative patients (12.3 ± 8.5 versus 9.0 ± 4.3 days, P = 0.076).

CONCLUSIONS:

Rib fixation with Stracos is feasible and decreases the length of ventilation and hospital stay. A multicenter randomized study is warranted so as to confirm these results and to evaluate impact on pulmonary function status, pain, and quality of life.

• Authors: Christophe P M Jayle, Géraldine Allain, Pierre Ingrand, Leila Laksiri, Emilie Bonnin, Jamil Hajj-Chahine, Olivier Mimoz, Pierre Corbi
• Journal: BioMed research international (Biomed Res Int) Vol. 2015 Pg. 624723 ( 2015) ISSN: 2314-6141 [Electronic] United States
• PMID: 25710011 (Publication Type: Controlled Clinical Trial, Journal Article)

Topics

• Bone Plates (statistics & numerical data)
• Female
• Flail Chest (surgery)
• Humans
• Intensive Care Units (statistics & numerical data)
• Length of Stay (statistics & numerical data)
• Male
• Middle Aged
• Multiple Trauma (therapy)
• Treatment Outcome
• Ventilators, Mechanical (statistics & numerical data)