全胸腔镜肋骨骨折复位内固定术与传统开放外固定术治疗多发肋骨骨折的疗效比较OA

Objective To compare the therapeutic efficacy of multicenter totally thoracoscopic reduction and internal fixation vs.traditional open external fixation in the treatment of multiple rib fractures.Methods A retrospective analysis was performed on the clinical data of 120 patients with multiple rib fractures from 4 medical institutions between December 2020 and June 2024.According to the different surgical procedures,the patients were divided into totally thoracoscopic group(treated with totally thoracoscopic reduction and internal fixation for rib fractures,n=60)and open group(treated with traditional open external fixation,n=60).The incision length,operation duration,intraoperative blood loss,postoperative drainage time,postoperative hospital stay,and incidence of postoperative complications were analyzed and compared between the two groups.Results Compared with open group,totally thoracoscopic group had significantly shorter incision length,less intraoperative blood loss,as well as shorter operative duration,postoperative drainage time,and postoperative hospital stay(P<0.05).The operative durations for anterior and posterior rib fractures in total thoracoscopic group were both significantly shorter than those in open group,with statistically significant differences(P<0.05).However,there were no statistically significant differences in the operative durations for lateral rib fractures,the incidence of complications,including poor fixation of the rib embracing fixator,poor fracture healing,and other adverse events between the two groups(P>0.05).Conclusions Compared with traditional open external fixation,totally thoracoscopic reduction and internal fixation for rib fractures has the advantages of minimal trauma,less bleeding,faster recovery,and higher success rate in the treatment of multiple rib fractures.It is particularly suitable for the treatment of anterior and posterior rib fractures,and allows simultaneous management of concomitant intrathoracic injuries.