Management of patients with flail chest by surgical fixation using claw-type titanium plate

Background: The goal of the study was to compare surgical rib fixation using claw-type titanium plate with conservative treatment in the management of patients with flail chest. Methods: The study retrospectively studied 23 patients suffering from flail chest injury, who admitted to our hospital from October, 2010 to February, 2014. The patients received surgical fixation by using claw-type titanium plate (surgical fixation group). A age and sex-matched cohort of 29 patients received conservative treatment and defined as conservative treatment group. Outcome variables included number of cases undergoing mechanical ventilation, ventilation time, time of hospital stay, incidence of respiratory complications, incidence of thoracic deformity and postoperative forced expiratory volume in the first second (FEV1). Results: Compared with conservative treatment group, surgical fixation group had fewer cases undergoing mechanical ventilation, shorter ventilation time, shorter hospital stay, lower incidence of respiratory complications and thoracic deformity and improved pulmonary function. Patients undergoing surgery earlier had shorter time of mechanical ventilation. Conclusions: Surgical rib fixation with claw-type titanium plate is a reliable and efficient method in the management of patients with flail chest.