Video-Assisted Thoracoscopic Surgical Rib Fixation for Costochondral Separation Injury

Costochondral separation is a rare phenomenon following blunt thoracic trauma that can also be associated with secondary injuries. We present a case with complete costochondral separation of the right second rib with concomitant mediastinal compression. Definitive treatment was provided through video-assisted thoracoscopic surgical plate osteosynthesis.

A Single-Center Experience of Osteosynthesis Material Infection after Rib Fixation for Blunt Trauma

Introduction There is no data regarding the incidence and treatment of deep infection affecting the surgical implants after rib fixation. The aim of this study is to share our experience in the management of infected material after surgical rib fixation. Methods The medical records of operated patients from January 2012 to December 2018 were retrospectively analyzed. Results Three patients out of 87 (3.44%) developed an infection. One patient was treated conservatively and two patients were operated for hardware removal. Conclusions The lack of evidence prompts for the design of surgical databases to share experience and enhance available data.

Surgical rib fixation: Five-year experience from an Australian trauma centre

Background Literature suggests surgical rib fixation in the acute phase of injury leads to positive outcomes. We have implemented this practice since 2014 and detail the outcomes of rib fixation from our institution. Methods We implement a multidisciplinary team management for chest injury. Failure to progress despite maximum intervention by the pain specialist is identified early leading to operative intervention. Retrospective 5-year review was performed on patients undergoing surgical rib fixation looking into the effect on pain scores, length of in hospital stay, post-operative complications and follow up. Results Thirty-seven cases (81% males) with a mean age of 56 met the inclusion criteria. All patients underwent rib fixation within 96 hours of admission. Of all included patients, 57% (n=21) required intensive care unit admission for ventilatory support. Of this subset of patients, 66% (n=14) were discharged to ward management within 48 hours, the remaining seven patients required ongoing support secondary to co-existing injuries requiring ongoing management in the unit. Post operatively, pain scores reduced at median of 2 days with a standard deviation of 2.5 days. The in-hospital stay also reduced by 155 hours (6 days) over the period of 5 years. There were two early complications in the series, but no mortality. At 28 days post operatively, both clinical and radiological follow up suggested no hardware or residual pulmonary complications. Conclusion This single institution study presents the early results of surgical rib fixation with satisfactory outcomes and minimal complications. Ongoing follow-up will provide a more detailed analysis of long-term outcomes Key Words Rib Fractures, Surgical stabilisation of rib fractures, Outcomes