title: [Internal fixation treatment of multiple rib fractures with absorbable rib-connecting-pins].
abstract: OBJECTIVE
  To study the indications, methods, and therapeutic effect of absorbable rib-connecting-pins fixation in the treatment of multiple rib fractures.
  
  
  METHODS
  Between March 2007 and September 2009, 40 patients with multiple rib fractures received internal fixation with absorbable rib-connecting-pins, including 8 one-side flail chest and 1 two-side flail chest. There were 32 males and 8 females with an average age of 39.8 years (range, 25-72 years). The injury was caused by traffic accident in 32 cases, falling from height in 6 cases, and blunt hitting in 2 cases. Preoperatively, imaging data of the chest X-ray or spiral CT three-dimensional (3D) examination showed that all patients had multiple ribs fractures and displacement. The number of fractured ribs was 4-10 (median, 6), and the fracture location ranged from the 2nd to the 10th ribs. Of them, 28 cases were accompanied by hemathorax, pneumothorax or hemopneumothorax; 5 cases by thoracic organ injury; and 10 cases by other part trauma. The time from injury to hospitalization was less than 1 day in 26 cases, 1-3 days in 12 cases, and 3-6 days in 2 cases, and the time from hospitalization to operation was 3 hours to 3 days (mean, 1.2 days).
  
  
  RESULTS
  The median fixation rib number was 5 (range, 3-8). The mean operative time, the time in bed, and hospitalization days were 32 minutes (range, 15-50 minutes), 4.5 days (range, 2-7 days), and 11.2 days (range, 5-18 days), respectively. All incisions healed by first intention. No pulmonary infection, pulmonary atelectasis, intrathoracic infection or other complications occurred. All cases were followed up 6-12 months (mean, 8 months). PaO2 [(86.6 +/- 2.2) mmHg (1 mm Hg = 0.133 kPa)] and SpO2 (97.2% +/- 0.6%) at 2 hours after operation were obviously improved when compared with preoperative ones (PaO2 (53.6 + 4.7) mm Hg and SpO2 (86.2% + 1.8%)], showing significant differences (t = 2.971, P = 0.005; t = 2.426, P = 0.020). The chest X-ray films or spiral CT 3D indicated that fracture of rib healed within 3-6 months (mean, 4.5 months) after operation.
  
  
  CONCLUSIONS
  Severe collapsed chest wall or flail chest caused by fracture of multiple ribs should be treated by absorbable rib-connecting-pins, which is a simple, firm, and effective method.
authors.affiliation: Department of Thoracic Surgery, First Hospital of Chinese PLA, Lanzhou Gansu, P.R. China. ljl.lz@163.com
authors.forename: Jinliang
authors.initials: J
authors.lastname: Liu
authors.forename: Keyao
authors.initials: K
authors.lastname: Li
authors.forename: Jianning
authors.initials: J
authors.lastname: He
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D001858:Bone Nails; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012253:Rib Fractures / Q000601:surgery*; D013898:Thoracic Injuries / Q000601:surgery