Respuesta del autor: Otra aplicación del sistema STRATOS para corrección de deformidades óseas del tórax (Pectux excavatum). Reoperación tras fracaso de un procedimiento de Ravitch / Author’s reply: Another application of the STRATOS system for the correction of chest wall deformities. Repeat surgery of pectus excavatum after failure of a Ravitch procedure

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Fijación quirúrgica de las fracturas costales con grapas y barras de titanio (sistema STRATOS). Experiencia preliminar / Surgical fixation of rib fractures with clips and titanium bars (STRATOS™ System). Preliminary experience

Introducción: Las fracturas costales son muy frecuentes en los traumatismos torácicos cerrados. La mayoría de estos pacientes tienen un dolor importante con los movimientos y con la tos. El objetivo de este estudio es valorar la utilidad de las grapas costales y barras de titanio en la estabilización de las fracturas costales. Material y métodos: Entre los años 2008 y 2009, veintidós pacientes con fracturas costales fueron tratados con reducción abierta y fijación interna Se definen las indicaciones para el tratamiento. 1) Pacientes con el tórax inestable (13 pacientes), 2) Pacientes con dolor o inestabilidad por fracturas costales (6 pacientes), 3) Deformidades traumáticas importantes de la pared torácica (3 pacientes). Los datos se analizaron de forma prospectiva. Se analizaron: edad, mecanismo traumático, lesiones torácicas y asociadas, datos intraoperatorios, complicaciones y seguimiento. Se describe la técnica quirúrgica. Resultados: La mayoría de los pacientes fueron extubados en el postoperatorio inmediato. Todos los pacientes con dolor o inestabilidad mostraron mejoría subjetiva o desaparición del dolor tras la cirugía. Cuatro pacientes presentaron infección de la herida que tuvo que ser drenada. Después de 3 meses el 55% de los pacientes había vuelto a su trabajo o a su vida habitual, y a los 6 meses el 91%. Se describen los resultados en cada grupo. Conclusiones: La reducción abierta con fijación interna de las fracturas costales, en un grupo seleccionado de pacientes, es una buena alternativa. La utilización de grapas costales y barras de titanio produce buenos resultados clínicos, su aplicación es fácil y tiene escasas complicaciones (AU)

Introduction: Rib fractures are very common in closed chest injuries. The majority of these patients suffer significant pain with movement and cough. The purpose of this study is to assess the usefulness of titanium rib bars and clips in stabilising rib fractures. Material and Methods: Twenty-two patients with rib fractures were treated with open reduction and internal fixation between 2008 and 2009. Indications for treatment were defined as; 1) Patients with unstable chest (13 patients), 2) Patients with pain or instability due to rib fractures (6 patients), and 3) Significant traumatic deformities of the chest wall (3 patients). Age, traumatic mechanism, chest and associated injuries, surgical data, complications and follow-up were prospectively analysed. The surgical technique is described. Results: The majority of patients were extubated immediately after surgery. All patients with pain or instability showed a subjective improvement or disappearance of pain after the surgery. Four patients had a wound infection which had to be drained. After 3 months, 55% of the patients had returned to work or normal life. The results in each group are described. Conclusions: Open reduction with internal fixation of rib fractures is a good alternative. The use of titanium rib bars and clips give good clinical results, are easy to apply and have few complications (AU)

[Surgical fixation of rib fractures with clips and titanium bars (STRATOS System). Preliminary experience]. / Fijación quirúrgica de las fracturas costales con grapas y barras de titanio (sistema STRATOS). Experiencia preliminar.

INTRODUCTION: Rib fractures are very common in closed chest injuries. The majority of these patients suffer significant pain with movement and cough. The purpose of this study is to assess the usefulness of titanium rib bars and clips in stabilising rib fractures. MATERIAL AND METHODS: Twenty-two patients with rib fractures were treated with open reduction and internal fixation between 2008 and 2009. Indications for treatment were defined as; 1) Patients with unstable chest (13 patients), 2) Patients with pain or instability due to rib fractures (6 patients), and 3) Significant traumatic deformities of the chest wall (3 patients). Age, traumatic mechanism, chest and associated injuries, surgical data, complications and follow-up were prospectively analysed. The surgical technique is described. RESULTS: The majority of patients were extubated immediately after surgery. All patients with pain or instability showed a subjective improvement or disappearance of pain after the surgery. Four patients had a wound infection which had to be drained. After 3 months, 55% of the patients had returned to work or normal life. The results in each group are described. CONCLUSIONS: Open reduction with internal fixation of rib fractures is a good alternative. The use of titanium rib bars and clips give good clinical results, are easy to apply and have few complications.