Unstable thorax fixation with bioabsorbable plates and screws. Presentation of some cases1

Abstract

Background: Flail chest is managed with mechanical ventilation or inhalation therapy, and analge- sia. Mechanical ventilations carry risks by themselves, and disengage with the external fixators, so they must be operated to improve lung ventilatory mechanics and cleaning. Little has been pub- lished on the use of bio-absorbable material and its evolution in the setting of flail chest. Material and methods: A study was made on a material that did not have to be removed, that had the malleability of steel, its inflammatory reaction was minimal, and could be handled in both adults and children. A descriptive study is presented of patients with flail chest under rib fixation with plates and bio-absorbable screws. Results: A series of 18 cases are presented, with ages from 33-74 years, three with bilateral flail chest. Fixation was performed between days 1-21 of the accident. In cases that showed no frac- tures of pelvic limbs, walking was restarted the day after fixing. In all cases mechanical ventila - tion improved and pain decreased. So far there has been no reaction to the material. Conclusions: Flail chest has a high (16.3%) mortality when the pathophysiology of the condition (pain, poor mechanical ventilation, alveolar oedema-pulmonary contusion) is not treated. The use of bio-absorbable material has no side effects attributable to material, making it another option for rib fixation.