The Effect Of Rib Fracture Open Reduction And Internal Fixation On The Patients With Severe Thoracic Injury

Objective:Rib fractures are one of the common chest trauma. Which caused severe chest trauma and more plural, multi-rib fractures. Undermining the integrity and stability of the thoracic movements. Produce abnormal breathing exercise, affect respiratory function and circulatory function in patients with severe cases can be life-threatening disease. Rib fractures in the past, generally take long bandaged chest strap is fixed, analgesic, ventilator-assisted breathing and other methods of conservative treatment, treatment difficulties, risks, complications, and long duration of the recovery time, the prognosis is poor,they all have failed to achieve satisfactory results. In recent years, rib fractures open reduction and internal fixation surgery and other treatment interventions in the treatment of severe chest trauma applications gradually increased. This study was conducted in patients with severe chest trauma grouping prospective controlled study to investigate the therapeutic effect of rib fractures with open reduction and internal fixation for the treatment of multiple rib fractures mainly of severe chest trauma and disadvantages.Method:Continuous choose Hebei Province People’s Hospital since January 2013 to December 2013 admitted to the hospital during treatment to multiple rib fractures as the main clinical manifestations of severe chest trauma patients 106 cases were randomly divided into 42 cases of surgical group, control group of 64 cases.Surgery patients rib fracture surgery patients received open reduction and internal fixation for the treatment, including 30 males and 12 females, mean age 54.40±14.29 years, the average number of 5.17±1.56 rib fractures roots admission pain index 7.60±1.17,2 hours after treatment, pain index 5.45±0.94,24 hours after treatment the mean pain index 4.67±1.03,48 hours after treatment the mean pain index 3.93±0.92, 72 hours after treatment the mean pain index 2.83±0.96, a total of 13 times of analgesics times, average 0.31 times/person, pulmonary complications nine cases (21.4%) after treatment, the average length of stay 11.14±1.84 days. The control group of patients treated conservatively, including 41 males and 23 females, mean age 53.39±12.47 years, the average number of 5.02± 1.84 rib fractures roots admission pain index 7.53±1.00,2 hours after the treatment of pain index 6.81±0.99,24 hours after treatment, the mean pain index 5.94±1.15,48 hours after treatment the mean pain index 5.75±1.29, 72 hours after treatment the mean pain index 5.45±1.25, the frequency of use of analgesics in total 75 times and an average of 1.2 times/person, after treatment 37 cases of pulmonary complications (57.8%), the average length of stay 17.41±7.72 days. Using SPSS 16.0 statistical software for data analysis. Measurement data, in line with normal distribution, mean±standard deviation, homogeneity of variance application if two independent t test, if the missing variance application t’test; count data using X2 test; grade data using two independent samples rank and test, P<0.05 was considered statistically significant. Were analyzed by age, sex, number of rib fractures of two groups of patients, admission, two hours after treatment,24 hours,48 hours,72 hours of pain scores, analgesic dosages, the incidence of pulmonary complications and length of stay and number of days the clinical data. A Comparative Study of rib fractures open reduction and internal fixation and conservative treatment in multiple rib fractures based treatment of severe chest trauma in the course of advantages and disadvantages.Results:There was no difference between two groups in age, gener, number of rid farctures or pain index of admission. However, in operation group, the pain index of 2 to 72 hours after treatment were lower (2 hours after treatment:5.45±0.94 vs.6.81±0.99, P=0.004,24 hours after treatment:4.67 ±1.03 vs.5.94±1.15, P=0.000,48 hours after treatment:3.93±0.92 vs.5.75 ±1.29, P=0.000,72 hours after treatment:2.83±0.96 vs.5.45±1.25, P=0.000), the incidence of pulmonary complications (9 vs.37, P=0.027), the use of pain-relief drugs (P=0.000) and the hospital stays were sooner (11.14± 1.84 vs.17.41±7.72,P=0.004).Conclusion:Compared with conventional treatment the open reduction and internal fixation can relieve pain, reduce the incidence of complications and shorten hospital stays for patients suffering from severe thoracic injury.