Artikel
Osteosynthesis in Ripfracture surgery – Plate or Splint?
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Autoren
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Y. P. Acklin
- Department of Surgery, Kantonsspital Graubünden, Chur
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R. M. Marquez-Pinilla
- Department of Surgery, Kantonsspital Graubünden, Chur
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M. Furrer
- Department of Surgery, Kantonsspital Graubünden, Chur
| Veröffentlicht: | 14. Oktober 2013 |
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Gliederung
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Objective: Conservative treatment of flail chest was the standard of care. In the last years, a possible benefit of surgical stabilization has been reported. Several possible osteosynthesis products e.g. plates or splints are commercially available.
Our goal was to evaluate the different treatment options and outcomes.
Methods: From August 2009 until April 2013, 160 severe thoracic traumata (AIS ≥3) were treated at our institution. In 21 patients, 94 rip osteosynthesis were performed using the MatrixRIB® system. Either splints or plates were used for fracture fixation. Sixteen patients were locally resident and a follow up could be obtained.
Results: The 21 patients were 57±11 years old and sustained a thoracic injury between AIS 3 to 5. The injury severity score was 21±8. On average, 4 rips were stabilized in 115±51 minutes operation time.
Of all implants, 5 splint tips perforated the rip in the postoperative course but all patients remained clinically asymptomatic. Plate osteosynthesis showed no loss of reduction in the postoperative course, corresponding to a p-value of >0.001 using the Fischer exact test. No infections occurred.
Conclusion: Recent published articles reported promising results with osteosynthesis in the treatment of rip fractures in selected cases. In our patients, we experienced significant more complications using splints compared to plates.
