Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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Clinical characteristics of patients with the hardware failure after surgical stabilization of rib fractures in Korea: a case series

  • Na Hyeon Lee (Department of Trauma and Surgical Critical Care, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Sun Hyun Kim (Department of Trauma and Surgical Critical Care, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Seon Hee Kim (Department of Trauma and Surgical Critical Care, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Dong Yeon Ryu (Department of Trauma and Surgical Critical Care, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Sang Bong Lee (Department of Trauma and Surgical Critical Care, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Chan Ik Park (Department of Trauma and Surgical Critical Care, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Hohyun Kim (Department of Trauma and Surgical Critical Care, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Gil Hwan Kim (Department of Trauma and Surgical Critical Care, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Youngwoong Kim (Department of Thoracic and Cardiovascular Surgery, National Medical Center) ;
  • Hyun Min Cho (Department of Trauma Surgery, Cheju Halla General Hospital)
  • Received : 2023.04.26
  • Accepted : 2023.06.14
  • Published : 2023.09.30
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Abstract

Purpose: Surgical stabilization of rib fractures (SSRF) is widely used in patients with flail chests, and several studies have reported the efficacy of SSRF even in multiple rib fractures. However, few reports have discussed the hardware failure (HF) of implanted plates. We aimed to evaluate the clinical characteristics of patients with HF after SSRF and further investigate the related factors. Methods: We retrospectively reviewed the electronic medical records of patients who underwent SSRF for multiple rib fractures at a level I trauma center in Korea between January 2014 and January 2021. We defined HF as the unintentional loosening of screws, dislocation, or breakage of the implanted plates. The baseline characteristics, surgical outcomes, and types of HF were assessed. Results: During the study period, 728 patients underwent SSRF, of whom 80 (10.9%) were diagnosed with HF. The mean age of HF patients was 56.5±13.6 years, and 66 (82.5%) were men. There were 59 cases (73.8%) of screw loosening, 21 (26.3%) of plate breakage, 17 (21.3%) of screw migration, and seven (8.8%) of plate dislocation. Nine patients (11.3%) experienced wound infection, and 35 patients (43.8%) experienced chronic pain. A total of 21 patients (26.3%) underwent reoperation for plate removal. The patients in the reoperation group were significantly younger, had fewer fractures and plates, underwent costal fixation, and had a longer follow-up. There were no significant differences in subjective chest symptoms or lung capacity. Conclusions: HF after SSRF occurred in 10.9% of the cases, and screw loosening was the most common. Further longitudinal studies are needed to identify risk factors for SSRF failure.

Keywords

Acknowledgement

This study was supported by a National Research Foundation of Korea (NRF) grant (No.2020R1F1A1052713), funded by the Ministry of Science and ICT of Korea; and Pusan National University Research Grant in 2020.

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