ABSTRACT
Objective To investigate the clinical efficacy of rib's strapping-traction technology using absorbable implants combined with memory-alloy ribs embracing fixator in treating multiple rib fractures under video-assisted thoracoscope.Methods A retrospective case control study was performed to analyze 178 patients with multiple rib fractures treated from January 2015 to June 2017.According to the operation method,all patients were divided into observation group (91 patients) and control group (87 patients).The observation group including 59 males and 32 females aged (39.7 ± 7.8)years adopted internal fixation by rib's strapping-traction technology using absorbable implants combined with memory alloy ribs embracing fixator under video-assisted thoracoscopic surgery.The control group including 56 males and 31 females aged (40.2 ± 6.9) years adopted internal fixation by conventional rib's clamping-traction technology using towel forcep combined with memory-alloy ribs embracing fixator under video-assisted thoracoscopic surgery.The incision length,single rib internal fixation time,number of internal fixation rib fractures,visual analogue scale (VAS) score on postoperative 1 d,postoperative chest drainage,postoperative hospital stay,and postoperative fracture healing were compared between the two groups.Results All patients were followed up for 3-30 months (mean,16.7 months).All operations were successful,with no case of thoracotomy.The observation group had shorter incision length [(4.3 ± 1.2) cm vs.(6.2 ± 1.7) cm] and single rib internal fixation time [(10.3±2.9)min vs.(14.1 ±2.3)min] than the control group (P＜0.05).There were no significant differences (P ＞ 0.05) between the two groups in number of internal fixation rib fractures [(5.7±.3.6) vs.(5.9±3.3)],postoperative chest drainage [(668.3 ±131.4)ml vs.(703.7±116.2)ml],postoperative hospital stay [(6.4 ± 1.8) d vs.(6.8 ± 1.7) d],the VAS score on postoperative 1 d [0-3 point,62％ vs.61％;4-6 point,38％ vs.39％],postoperative osteophyte formation rate [postoperative 1 month,97％ vs.95％;postoperative 3 months,100％ vs.100％].Stable chest walls and thoracic deformity recovery were seen in all patients,with no significant complications occurred.Conclusion Rib's strapping-traction technology using absorbable implants combined with memory-alloy ribs embracing fixator under video-assisted thoracoscope is convenient and has exact efficacy for multiple rib fractures,with advantage of shorter incision length and operation time over conventional thoracoscopic surgery,and thus is worthy of clinical application.