medigraphic.com
ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2016, Number 6

<< Back Next >>

Acta Ortop Mex 2016; 30 (6)

Thoracic inestability fixed with bioabsorbable screws and plates

Nolasco-de la Rosa AL, Mosiñoz-Montes R, Matehuala-García J, Cuautle-Ramírez AA, Román-Guzmán E, Reyes-Miranda AL, Quero-Sandoval F

Language: Spanish
References: 18
Page: 311-315
PDF size: 450.15 Kb.


ABSTRACT

Background: Flail chest is managed with mechanical ventilation or inhaloteraphy and analgesia. Little has been published on the use of bioabsorbable material and its evolution in flail chest fixation. Methods: This is a descriptive study of patients with unstable chest undergoing fixation with bioabsorbable plates and screws in a period from February 2009 to December 2011. Results: We report 18 cases, aged 33-74 years (mean 53), three with bilateral involvement; rib fixation was performed between 1-21 days of the accident (mean 1.5). They started walking the next day in 14 cases; postoperative stay was four days (range 3-14). The heart rate of patients prior to surgery was 90 per minute (range 82-100) and lowered to 84 after fixation (range 82-92), preoperative respiratory rate was 26 per minute (range 22-28) and below 22 per minute (range 20 to 26) in postoperative period. Conclusions: The use of bioabsorbable material for osteosynthesis of costal fractures did not show side effects in our period of study.


REFERENCES

  1. Wilson RF: Trauma. Accidental and surgical trauma. En: Shoemaker, textbook of critical care. 2ª ed. Saunders, 1989.

  2. Simon B, Ebert J, Bokhari F, Capella J, Emhoff T, Hayward T 3rd, et al: Management of pulmonary contusion and flail chest. J Trauma Acute Care Surg. 2012; 73(5 Suppl 4): S351-61.

  3. Liovic P, Šutalo ID, Marasco SF: Stress analysis of a centrally fractured rib fixated by an intramedullary screw, computer methods in biomechanics and biomedical engineering. Journal Computer Methods in Biomechanics and Biomedical Engineering. 2012; 1: 944-57.

  4. García GA, Torres PO, Álvarez VJ, Alino BO, Escoto JC: Lesiones del tórax en los politraumatizados. Estudio particular de las lesiones del esqueleto torácico. Rev Cuba Cir. 2003; 22(5): 405-24.

  5. Marasco SF, Davies AR, Cooper J, Varma D, Bennett V, Nevill R, et al: Prospective randomized controlled trial of operative rib fixation in traumatic flail chest. J Am Coll Surg. 2013; 216(5): 924-32.

  6. Marasco SF, Liovic P, Šutalo ID: Structural integrity of intramedullary rib fixation using a single bioresorbable screw. J Traum Acute Care Surg. 2012; 73(3): 668-73.

  7. Voggenreiter G, Neudeck F, Aufmkolk M, Obertacke U, Schmit-Neuerburg KP: Operative chest wall stabilization in flail chest-outcomes of patients with or without pulmonary contusion. J Am Coll Surg. 1998; 187: 130-8.

  8. Balci AE, Eren S, Cakir O, Eren MN: Open fixation in flail chest: review of 64 patients. Asian Cardiovasc Thorac Ann. 2004; 12: 11-5.

  9. Torriente F, Fernández E, Guerrero L, Fernández P, López L: Tratamiento de las fracturas costales múltiples con grapas de Judet. A propósito de 10 casos. Cir Esp. 1980; 34(2): 141-4.

  10. Carlile BB, Sutton J, Pand Stepheson SE: New technic for stabilization of the flail chest. Am J Surg. 2006; 112(7): 133.

  11. Trinkle JK, Richardson JD, Franz JL, Grover FL, Arom KV, Holmatrom FM: Management of flail chest without mechanical ventilation. Ann Thorac Surg. 2005; 19: 335-63.

  12. Freedland M, Wilson RF, Bender JS, Levison MA. The management of flail chest injury: factors affecting outocome. J Traum. 2010; 30(12): 1460-8.

  13. Barzilay E, Lev A, Ibrahim M, Lemes C: Traumatic respiratory insufficiency: comparison of conventional mechanical ventilation to high-frequency positive pressure with low-rate ventilation. Crit Care Med. 2008; 15(2): 118-21.

  14. Lardinois D, Krueger T, Dusmet M, Ghisletta N, Gugger M, Ris HB: Pulmonary function testing after operative stabilization of the chest wall for flail chest. Eur J Cardiothorac Surg. 2001; 20: 496-501.

  15. Tanaka H, Yukioka T, Yamaguti Y, Shimizu S, Goto H, Matsuda H, et al: Surgical stabilization of internal pneumatic stabilization? A prospective randomized study of management of severe flail chest patients. J Trauma. 2002; 52: 727-32.

  16. Athanassiadi K, Gerazounis M, Theakos N: Management of 150 flail chest injuries: analysis of risk factors affecting outcome. Eur J Cardiothorac Surg. 2004; 26: 373-6.

  17. Ricalde P, Caccamese J, Norby C, Posnick JC, Hartman MJ, Von Fraunhofer JA. Strength analysis of 6 resorbable implant systems: does heating affect the stress-strain curve? J Oral Maxillofac Surg. 2008; 66: 2493-7.

  18. Marasco SF, Šutalo ID, Bui AV: Mode of failure of rib fixation with absorbable plates: a clinical and numerical modeling study. J Trauma. 2010; 68(5): 1225-33.




2020     |     www.medigraphic.com