3D printing and thoracoscopy assisted MIPO in treatment of long-range comminuted rib fractures, a case report

Zhou, Xuetao; Zhang, Dongsheng; Xie, Zexin; Chen, Menghui; Yang, Yang; Zheng, Liang; Zhang, Guoliang

doi:10.1186/s13019-019-0892-0

Cited by 4 publications

(2 citation statements)

References 12 publications

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“…Future directions for SSRF may include the following: (1) intrathoracic thoracoscopic minimally invasive plate osteosynthesis, (2) customization of plates using preoperative manufacturing of patient-specific contoured plates based on preoperative 3-dimensional printing 37 , (3) absorbable plates and screws, (4) low-profile, fatigue-free material plates (e.g., carbon fiber), and (5) fixation with a shape-memory alloy 31 .…”

Section: Resultsmentioning

confidence: 99%

Surgical Stabilization of Rib Fractures

Fokin

Hus

Rodríguez

et al. 2020

JBJS Essential Surgical Techniques

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Background: Rib fractures are a common thoracic injury that is encountered in 20% to 39% of patients with blunt chest trauma and is associated with substantial morbidity and mortality 1 , 2 . Traditionally, the majority of patient with rib fractures have been managed nonoperatively. Recently, the utilization of surgical stabilization of rib fractures has increased considerably because the procedure has shown improved outcomes 3 - 5 . Description: Surgical stabilization should be considered in cases of multiple bicortically displaced rib fractures, especially in those with a flail chest and/or a concomitant ipsilateral displaced midshaft clavicular fracture or sternal fracture, as such cases may result in thoracic wall instability. For surgical stabilization of rib fractures, we classify rib fractures by location, type of fracture, and degree of displacement after obtaining thin-sliced chest computed tomography (CT) scans. The incision is selected depending on the fracture location, and the surgical technique is chosen relevant to the type of fracture. Single-lung intubation is preferred if there is no severe contralateral pulmonary contusion. We favor performing video-assisted thoracoscopy if possible to control bleeding, evacuate hematomas, repair a lung, and perform cryoablation of the intercostal nerves. A lateral approach is considered to be the main surgical approach because it allows access to the majority of rib fractures. A curvilinear skin incision is made overlying the fractured ribs. Posterior rib fractures are exposed through a vertical incision within the triangle of auscultation, and anterior fractures, through a transverse inframammary incision. The muscle-sparing technique, splitting alongside fibers without transection, should be utilized if possible and supplemented by muscle retraction. For surgical stabilization of rib fractures, we currently prefer precontoured side and rib-specific plates with threaded holes and self-tapping locking screws. Polymer cable cerclage is used to enhance plating of longitudinal fractures, rib fractures near the spine, osteoporotic ribs, and injuries of rib cartilage. The third to eighth ribs are plated most often. Intercostal muscle deficit, if present, is repaired with a xenograft patch. In comminuted rib fractures, the bone gap is bridged with bone graft. Surgical stabilization of rib fractures is recommended within the first 7 days after trauma, preferably within the first 3 days 6 - 8 . Alternatives: Nonoperative treatment alternatives include (1) epidural analgesia when not contraindicated because of anticoagulant venous thromboembolism prophylaxis 9 , 10 ; (2) thoracic paravertebral blockage, e.g., serratus anterior or erector spinae plane nerve block ...

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Section: Resultsmentioning

confidence: 99%

Surgical Stabilization of Rib Fractures

Fokin

Hus

Rodríguez

et al. 2020

JBJS Essential Surgical Techniques

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“…Although there was no significant difference in the rate of fixation loss between the two groups, it is worth noting that the 3D printing group exhibited a lower rate of fixation loss compared to the non-3D printing group. Zhou et al assisted in the preoperative 3D rib model to achieve accurate and individualized treatment of complex rib fractures such as multiple multi-segment rib fractures, high rib fractures, pectoralis major muscle coverage area or scapular coverage area, and shorten the operation time, lowered the difficulty of operation, reduce the injury of patients, and perfect recovery of thoracic shape, the effect is ideal [ 23 , 24 ]. Moreover, Chen et al reported that compared with the non-3D printing group, planned surgery with 3D rib model significantly reduced the fixation time of each fracture, shorten the incision length.…”

Section: Discussionmentioning

confidence: 99%

Application of preoperative 3D printing in the internal fixation of posterior rib fractures with embracing device: a cohort study

et al. 2023

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Background To explore the impact of preoperative 3D printing on the fixation of posterior rib fractures utilizing a memory alloy embracing device of rib under thoracoscopy. Methods The enrolled patients were divided into the 3D printing (11 patients) and the non-3D printing (18 patients) groups, based on whether a 3D model of ribs was prepared prior to surgery. Analysis was conducted comparing the average fixation time per fracture, postoperative fixation loss, and poor reduction of fractured end between the two groups. Results The average fixation time of each fracture was 27.2 ± 7.7 min in the 3D printing group and 29.3 ± 8.2 min in the non-3D printing group, with no statistically significant difference observed between the two groups (P > 0.05). The incidence of poor fracture fixation in the 3D printing group was statistically lower than that in the non-3D printing group (12.9% vs. 44.7%, P < 0.05). Further stratified analysis revealed that the off-plate rate in the 3D printing group and the non-3D group was (3.2% vs. 12.8%, P > 0.05), and the dislocation rate of the fractured end was (9.7% vs. 31.9%, P < 0.05). Conclusions The application of 3D printing technology to prepare the rib model before surgery is proves beneficial in reducing the occurrence of poor fixation of fractures and achieving precise and individualized treatment.

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The Chinese consensus for surgical treatment of traumatic rib fractures 2021 (C-STTRF 2021)

Kong

Huang

et al. 2021

Chinese Journal of Traumatology

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3D printing and thoracoscopy assisted MIPO in treatment of long-range comminuted rib fractures, a case report

Cited by 4 publications

References 12 publications

Surgical Stabilization of Rib Fractures

Surgical Stabilization of Rib Fractures

Application of preoperative 3D printing in the internal fixation of posterior rib fractures with embracing device: a cohort study

The Chinese consensus for surgical treatment of traumatic rib fractures 2021 (C-STTRF 2021)

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