Метод фиксации костных отломков флотирующих переломов ребер

Abstract

Aim. Comparative analysis of the results of surgical and nonsurgical fixation of floating rib fractures (FRF).Material and methods. The results of the treatment of 141 patients with FRF hospitalized in the RRCEM from 2017 to 2022 were studied. There were 109 men (77.3%), 32 women (22.7%). The averageage of patients was 37.8±13.5 years. All 141 patients with FRF underwent video thoracoscopy (VTS),upon completion of which two approaches were used to fix floating rib fractures: the traditional method is internal pneumatic stabilization of floating rib fractures (long-term artificial lung ventilation(ALV)) – in 85 (60.3%) patients and external rib fixation under the control of the VTS – in 56 (31.3%)patients.Results. The use of external fixation of FRF under the control of VTS helps to reduce the duration ofventilation (from 8.2±2.5 days to 2.1±1.0 days, p<0.001) and, accordingly, the length of stay of patientsin the ICU (from 9.2±2.9 days to 3.8±2.1 days, p<0.001), reduces the frequency of severe post-traumaticpneumonia (from 64.7 to 17.9%, p<0.001), which has a beneficial effect on the mortality rate, reducing itfrom 15.3% to 7.1% (p>0.05).Conclusion. The use of VTS, along with safe and reliable fixation of rib fractures, also provides full-fledgedsanitation of the pleural cavity from hemothorax, allows minimally invasive hemostasis and eliminate other intrapleural consequences of trauma, which together contributes to a significant reduction in the timeof removal of pleural drains (from 4.3±1.0 days to 5.6±1.7 days, p<0.05).