TREATMENT OF MULTIPLE RIB FRACTURES WITH THORACOSCOPIC EXPLORATION AND INTERNAL FIXATION

Jianwen Huang¹, Xin Zang², Wenda Gu², Zhihua Long¹, Guohai Chen¹, Xuewen Zheng^{3, *} 

¹Department of Thoracic Surgery, Luoding People's Hospital, Luoding 527200, PR China - ²Department of Heart Research Institute, Guangdong People's Hospital, Guangzhou 510080, PR China - ³Department of Thoracic Surgery, Overseas Chinese Hospital in Puning, Puning 515300, PR China

Objective: To explore the therapeutic effect of thoracoscopic exploration combined with internal rib fixation on patients with multiple rib fractures 

Methods: A total of 126 patients with multiple rib fractures admitted to our hospital from August 2017 to June 2019 were randomly divided into two groups. The patients in the control group (63 cases) were treated with conventional internal fixation of the ribs, while those in the study group (63 cases) were treated with thoracoscopic-assisted exploration and internal fixation of the ribs. After treatment, the curative effect indexes (e.g., time until chest pain relief, operation time, amount of bleeding); and postoperative recovery time and hospitalization time (e.g., time until removal of chest drainage tube, time until chest pain relief, time until patient leaves bed) were measured. In addition, postoperative complications (e.g., atelectasis, incision infection, and chest infection), normal rate of lung re-expansion, fracture contraposition rate, and incision infection rate were compared and analysed between the two groups. 

Results: After treatment, the relief time, operation time and bleeding volume in the study group were significantly lower than those of the control group (P<0.01). After treatment, the time until removal of the thoracic drainage tube, relief of chest pain, time until ambulation and length of hospitalisation in the study group were significantly lower than those in the control group (P<0.01). After treatment, the total complication rate of the study group was significantly lower than that of the control group (P<0.01). After treatment, the rates of atelectasis, fracture alignment and incision infection in the study group were significantly higher than those in the control group (P<0.01). 

Conclusion: Thoracoscopic exploration combined with internal rib fixation can effectively reduce the incidence of pulmonary atelectasis, thoracic infection and other complications in patients with multiple rib fractures, improve patients’ quality of life, shorten the length of hospitalisation, reduce operation time and improve recovery time. The procedure’s high safety profile makes it worthy of clinical application.