BIOMECHANICAL AND PHYSIOLOGICAL PRINCIPLES APPLIED IN CHEST WALL RECONSTRUCTION ASSOCIATED WITH RIB FRACTURES

Abstract

TYPE: Abstract TOPIC: Cardiothoracic Surgery PURPOSE: The aim of this study was to describe osseointegration of osteosynthesis material and risk of surgical intervention when biomechanical and physiological principles are applied in chest wall reconstruction (CWR). METHODS: All adult patients with pulmonary contusion, multiple rib fractures, flail chest, hemothorax or pneumothorax associated with rib fractures who underwent CWR between March 2012 and December 2016 in emergency department retrospectively included.Titanium clips pressure-fitted at 2 cm proximal and distal were used at each fracture site. Curvature of the clip was made to simulate the natural curvature of the costal arch. In all cases the vascular and nervous package was released. Postoperative follow-ups were obtained from medical records and the integration of the osteosynthesis material was assessed. RESULTS: The 60 patients were 37 men and 23 woman, average age of 44 years. Hospital stays between 7 and 16 days. At 30 days postoperative complications had been recorded such as respiratory insufficiency (n=2) and acute myocardial infarction (n=1).Osteointegration of the osteosynthesis material was found in 59 patients (98.3%) and 1 patient (1.6%) present refracture and mobilization of a titanium implant, for which it was surgery reintervened and the defect corrected CONCLUSIONS: In our study, we found a very high percentage of osseointegration when using the biomechanical principles in the techniques for CWR. CLINICAL IMPLICATIONS: The healing process near fracture sites relies in a correct immobilization,adequate vascularization and formation of bone callus and new bone therefore, by using titanium clips combined with different biomechanical principles they help this purpose by improving the conditions at the fracture site. DISCLOSURE: Nothing to declare. KEYWORD: CHEST WALL RECONSTRUCTION