Đặc điểm lâm sàng và kết quả sớm của cố định mảng sườn di động bằng nẹp vít tại Bệnh viện Hữu nghị Việt Đức

Flail chest is a critical condition resulting from severe thoracic trauma, characterized by paradoxical chest wall movement and significant respiratory and circulatory compromise, carrying a high risk of mortality if untreated. Surgical stabilization, particularly through plate fixation, has emerged as a crucial intervention to restore chest wall integrity and improve patient outcomes. Despite its growing adoption globally, comprehensive reports on the early outcomes of this surgical technique within the Vietnamese context remain limited. This study aims to address this gap by investigating the clinical and paraclinical characteristics and evaluating the early outcomes of plate fixation for flail chest at Viet Duc University Hospital over the period 2020-2024, emphasizing its importance in modern trauma care.

Thoracic surgeons, trauma specialists, intensivists, and medical researchers interested in the surgical management and outcomes of flail chest.

This retrospective descriptive study investigated the clinical and paraclinical characteristics and early outcomes of plate fixation for flail chest in 32 patients at Viet Duc University Hospital from January 2020 to August 2024. The patient cohort had a mean age of 47.92 years, predominantly male (65.6%), with road traffic accidents being the primary cause (75%). The mean Injury Severity Score (ISS) was 25.25, indicating severe polytrauma. Common clinical presentations included chest pain (81.25%) and decreased breath sounds (100%), often accompanied by subcutaneous emphysema. The lateral chest wall was the most frequent site of flail chest (78.1%), with an average of 9.06 fractured ribs detected by CT scan. Surgical plate fixation predominantly targeted ribs IV-VII, utilizing an average of 2.91 plates. In 59.4% of cases, rib fixation was combined with management of intrathoracic injuries. Postoperatively, 34.4% of patients required mechanical ventilation, and 37.5% were admitted to the intensive care unit. Common complications included pneumonia (31.3%) and respiratory failure (25%), with one death (3.1%). The mean postoperative hospital stay was 10.72 days. The study concludes that plate fixation for flail chest is a safe and effective surgical method for managing severe thoracic trauma, leading to early improvements in respiratory function, pain control, and restoration of chest wall stability. Despite the positive findings, limitations include a small sample size and short follow-up period, suggesting a need for larger, longitudinal studies.