Comparative studies of different types of osteosynthesis on the human corpse preparation in bilateral antero-lateral flail chest
| Autor: | Sina Grupp, Thomas Buder, Alexander Fichte, Stefan Schulz-Drost, Sebastian Krinner, Friedrich F. Hennig, Andreas Langenbach, R. Carbon, Veronika Fürst |
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| Rok vydání: | 2017 |
| Předmět: |
Thorax
Sternum Flail chest Thoracic Injuries Locking plate Fracture Fixation Internal 03 medical and health sciences 0302 clinical medicine Cadaver Flail Chest medicine Humans Displacement (orthopedic surgery) Thoracic Wall General Environmental Science 030222 orthopedics Rib cage Osteosynthesis business.industry 030208 emergency & critical care medicine Anatomy medicine.disease Sagittal plane Osteotomy medicine.anatomical_structure General Earth and Planetary Sciences business Bone Plates |
| Zdroj: | Injury. 48:2709-2716 |
| ISSN: | 0020-1383 |
| Popis: | Introduction Bilateral flail chest injuries are challenging in treatment and comparatively often require an operative stabilization of the anterior chest wall to re-establish normal physiological conditions of the chest wall in shape and statics. Various procedures have been described which are technically sophisticated for the surgeon. Consequently there is an increasing interest in potentials of operative care and their effectiveness on the anterolateral chest wall. Materials and methods 12 Human cadavers were prepared and the natural Sternum Position (NP) was marked. A digital probe was fixed to the sternum at the height of the 4th intercostal space in order to measure and compare the stability of the thorax. Readings were taken of the sternal displacement at 1–5 cm sagittal distance from NP in starting conditions and from every combination of materials. Serial osteotomies were performed on 2 locations on ribs 2–8 to induce bilateral flail chest. Afterwards the stabilization was achieved with different implants: – Transsternal metalstrut. – Several combinations of locking plate fixation. Results The osteotomies lead to a subsidence of the sternum occurred to almost 75 mm from NP which corresponds to a maximal unstable situation. The unstable chest wall showed substantially more stabilization through the use of locking plates. Our materialcombinations showed a stability of up to 60% of normal. The more ribs were treated osteosynthetically, the higher the stability of the chest wall. Discussion and conclusions Locking plate fixation offers anatomically realignment of the ribs whereas metal strut support only lifts up the chest wall, but could not provide realignment of the dislocated ribs. |
| Databáze: | OpenAIRE |
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