Pure titanium rib plate fixation treats rib facture: pain analysis compared with conservative treatment

doi:10.3969/j.issn.2095-4344.1260

Abstract

Abstract:

BACKGROUND: Existing studies have shown that open reduction and internal fixation is superior to the conservative treatment. However, due to the poor understanding of new concept of rib fracture and lack of high-quality evidence, the application in the treatment of rib fracture remains controversial.

OBJECTIVE: To investigate the effect of titanium rib plate fixation in the treatment of rib fracture on pain relief.

METHODS: One hundred and eighty-seven cases of rib fractures were selected, and then allocated into surgical (n=79) and conservative (n=108) groups. The surgical group was given thoracoscopy-assisted small incision or traditional incision pure titanium rib plate fixation under anesthesia with double lumen tube and artery and central vein catheterized. All surgeries were completed within 1 week after trauma, 68 cases completed within 3 days (86%), and 11 cases were completed within 3-7 days (14%). The number and parts of rib fractures, hemopneumothorax and chest tube placement were recorded. The pain scores in the surgical (preoperative 1 day, postoperative 1 and 2 days) and conservative (1 and 2 days post-injury) groups were detected and compared.

RESULTS AND CONCLUSION: (1) No case died in both groups. There were two cases of incision infection in the surgical group, and the sinus canal communicated with the plate after long-term dressing. The plate was removed at postoperative 34 and 42 days, and the wound was healed. The remaining patients discharged successfully or underwent other trauma treatment. (2) There were 468 (5.92±2.17 mean) fractured ribs in the surgical group, and 382 fractured parts (6.92±2.91 mean). There were 373 (3.45±1.38 mean) fractured ribs in the conservative group, and 382 fractured parts (3.54±1.54 mean). There was significant difference in the number and parts of rib fracture between two groups (both P < 0.01). (3) The pain score showed significant difference between conservative (908, 2.86±0.36) and surgical (400, 2.13±0.41) groups (P < 0.01), suggesting that the pain was significantly alleviated in the surgical group compared with the conservative group. (4) The single day score in the surgical group was significantly lower than that in the conservative group (P < 0.05). In the surgical group, the pain score at postoperative 1 day was significantly higher than that at postoperative 2 days (P < 0.01). (5) In summary, pure titanium rib plate fixation can effectively alleviate the pain of rib facture within 1 week after trauma.

Key words: rib fracture, pure titanium, rib plate fixation, pain, internal fixation, conservative treatment, incision infection

CLC Number:

R459.9

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R459.9

Wang Zuopei, Xie Xinjie, Sheng Bo, Ding Yi, Lu Yi, Cheng Mengqi. Pure titanium rib plate fixation treats rib facture: pain analysis compared with conservative treatment[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(22): 3512-3517.

Figures/Tables 6

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