Rib osteosynthesis in thoracic trauma: a six-year single-center experience

Abstract

Introduction: Rib fractures represent one of the main injuries in blunt thoracic trauma, with a significant impact on hospital morbidity and mortality. Surgical rib fixation has become an effective strategy to improve respiratory function and reduce complications. Objective: To describe the experience of the Thoracic Surgery Service at Hospital Agramont (El Alto, Bolivia) in the surgical management of rib fractures secondary to blunt thoracic trauma between 2018 and 2023. Materials and Methods: A descriptive, retrospective, and quantitative study of forty-one patients with blunt thoracic trauma who underwent rib fixation. Demographic variables, trauma mechanisms, anatomical characteristics of the fractures, surgical approaches, and clinical outcomes were analyzed. Results: Sixty-one percent of patients were male, with a mean age of 44 years. Traffic accidents accounted for 92.7% of cases of vehicle collisions. A total of 53.6% required ICU admission, with an average stay of 6.1 days. The average number of fractures was seven per patient, with 91% undergoing surgical fixation. Flail chest was present in 51.2% of cases. The most common approaches were the extended vertical axillary thoracotomy (TAVA) and the sternal approach, with an average operative time of 141 minutes. The average hospital stay was 13 days, with no severe postoperative complications reported. Conclusion: The experience at Hospital Agramont shows that surgical rib fixation is a safe and effective option in the management of blunt thoracic trauma with multiple or unstable fractures, allowing for adequate functional recovery and a reduction in respiratory complications