Open Reduction And Internal Fixation Of Flail Chest Meta-analysis

Objective: Flail chest(FC)is a life-threatening complication of severe chest trauma with a high mortality rate.FC non-operative management treated with supportive ventilation and analgesia.The non-operative management has high bad consequences with pneumonia?tracheostomy rate?mortality and often leads to extended Intensive Care Unit(ICU)stay and total hospital stay,due to insufficient respiratory function and complications.The purpose of this research study was to compare the results of operative treatment and non-operative management for flail chest injuries.Methods: A systematic review of previously published comparative studies using operative and non-operative management of flail chest was performed from 1995 to 2015.PubMed,Medline,and Google Scholar were used for study identification.We compared operative to non-operative management in adult flail chest patients.Mean difference and other information for mortality,pneumonia rate,duration of mechanical ventilation,duration of ICU stay,duration of hospital stay,tracheostomy rate was statistic calculated by these publication results.Results: Three randomized-controlled trials and three retrospective trials were included in this systematic review.In total,there were 112 patients receiving operative management compared to 198 patients in the non-operative management group.Compared with non-operative management,operative management of FC was associated with lower mortality(OR=0.25,95%confidence interval(CI):0.09-0.68),risk ratio for pneumonia(0.22;95%CI:0.07-0.69),and tracheostomy(0.26;95% CI: 0.1-0.68),and short DMV [ES:-0.75 days;95% CI:-1.13to-0.37],duration of ICU stay(-1.32 day 95% CI:-2.25 to-0.39),duration of hospital stay(-3.74days;95% CI:-10 to-2.53).Conclusion: Despite the relatively small number of patients included,the results of this meta-analysis suggest operative management of flail chest injuries may have substantial benefits in many aspects.At present,the analyses are based on the retrospective studies.So like this study need to be investigated with large randomized controlled trials,and the research content also should be more abundant than before.