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Volume 2022, Issue 2
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

Recent evidence showed improved outcomes in surgical fixation, compared to conservative management, of flail chest and severe non-flail rib fractures patterns. The dedicated rib fixation systems are expensive and not available in most hospitals. This study aims to establish the feasibility of surgical stabilization of traumatic rib and sternum fractures with off-label utilization of cranio-maxillo-facial surgery titanium implants. Case series where data of patients, who underwent surgical stabilization of traumatic rib or sternum fractures with off-label utilization of cranio-maxillo-facial surgery titanium implants at Bufalini Hospital in Cesena, Italy, were retrospectively collected. From August 2018 to June 2020, 13 patients were included. The mean operative time was 87.5 minutes (median ± SD: 85 ± 27.1). Post-operative complications were: pneumonia (46.2%), sepsis (7.7%) and superficial wound infection (15.4%). No patients underwent reintervention. No infection or displacement of plates occurred. The costs of the most utilized titanium plates and screws in our series (∅ 2.3–2.5 mm KLS Martin®) were 122–245 € for one plate and, 13 € for a pack of five screws. The present study showed the feasibility of the off-label use, for rib stabilization, of devices from cranio-maxillo-facial surgery, usually easily available in hospitals and, in particular, in trauma centers, also without elective thoracic surgery departments. These devices are cheaper than the most widely utilized rib fixation systems and, being easily available in hospitals, could be used in urgent settings and could avoid the delay of rib fixation if dedicated thoracic fixation systems are not available. They could have a role also in low-income countries.

© 2022 Fugazzola, Casadei, Rosato, Favi, Tomasoni, Improta, Zaghi, Russo, Coccolini, Santonastaso, Gamberini, Agnoletti, Ansaloni, licensee HBKU Press.
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2022-02-03
2024-11-15
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/content/journals/10.5339/jemtac.2022.12
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Feasibility and cost-effectiveness of surgical stabilization of traumatic rib and sternum fractures with off-label utilization of cranio-maxillo-facial surgery titanium implants: Case series
Journal of Emergency Medicine, Trauma and Acute Care 2022, 12 (2022); https://doi.org/10.5339/jemtac.2022.12
/content/journals/10.5339/jemtac.2022.12
/content/journals/10.5339/jemtac.2022.12
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  • Article Type: Research Article
Keyword(s): flail chest, rib fractures, rib stabilization and sternum fractures

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