title: Flail chest in polytraumatized patients: surgical fixation using Stracos reduces ventilator time and hospital stay.
abstract: OBJECTIVE
  Conservative management of patients with flail chest is the treatment of choice. Rib fracture repair is technically challenging; however, with the advent of specially designed molding titanium clips, surgical management has been simplified. Surgical stabilization has been used with good outcomes. We are reporting on our institutional matched-case-control study.
  
  
  METHODS
  Between April 2010 and April 2011, ten polytraumatized patients undergoing rib stabilization for flail chest were matched 1 : 1 to 10 control patients by age ±10 years, sex, neurological or vertebral trauma, abdominal injury, and arm and leg fractures. Surgery was realized in the first 48 hours.
  
  
  RESULTS
  There were no significant differences between groups for matched data and prognostic scores: injury severity score, revised trauma score, and trauma injury severity score. Ventilator time (142 ± 224 versus 74 ± 125 hours, P = 0.026) and overall hospital stay (142 ± 224 versus 74 ± 125 hours, P = 0.026) were significantly lower for the surgical group after adjustment on prognostic scores. There was a trend towards shorter ICU stay for operative patients (12.3 ± 8.5 versus 9.0 ± 4.3 days, P = 0.076).
  
  
  CONCLUSIONS
  Rib fixation with Stracos is feasible and decreases the length of ventilation and hospital stay. A multicenter randomized study is warranted so as to confirm these results and to evaluate impact on pulmonary function status, pain, and quality of life.
authors.affiliation: Thoracic and Cardiac Surgery Unit, INSERM 1082, Poitiers University Hospital, 2 rue de la Milétrie, 86000 Poitiers, France.
authors.forename: Christophe P M
authors.initials: CP
authors.lastname: Jayle
authors.affiliation: Thoracic and Cardiac Surgery Unit, Poitiers University Hospital, 2 rue de la Milétrie, 86000 Poitiers, France.
authors.forename: Géraldine
authors.initials: G
authors.lastname: Allain
authors.affiliation: Epidemiology & Biostatistics, INSERM CIC0802, Poitiers University Hospital, 2 rue de la Milétrie, 86000 Poitiers, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Ingrand
authors.affiliation: Intensive Care Unit, Poitiers University Hospital, 2 rue de la Milétrie, 86000 Poitiers, France.
authors.forename: Leila
authors.initials: L
authors.lastname: Laksiri
authors.affiliation: Thoracic and Cardiac Surgery Unit, Poitiers University Hospital, 2 rue de la Milétrie, 86000 Poitiers, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Bonnin
authors.affiliation: Thoracic and Cardiac Surgery Unit, Poitiers University Hospital, 2 rue de la Milétrie, 86000 Poitiers, France.
authors.forename: Jamil
authors.initials: J
authors.lastname: Hajj-Chahine
authors.affiliation: Intensive Care Unit, Poitiers University Hospital, 2 rue de la Milétrie, 86000 Poitiers, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Mimoz
authors.affiliation: Thoracic and Cardiac Surgery Unit, Poitiers University Hospital, 2 rue de la Milétrie, 86000 Poitiers, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Corbi
mesh_terms: D001860:Bone Plates / Q000706:statistics & numerical data*; D005260:Female; D005409:Flail Chest / Q000601:surgery*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000628:therapy; D016896:Treatment Outcome; D012122:Ventilators, Mechanical / Q000706:statistics & numerical data*