Short-term follow-up of single-port thoracoscopic rib fracture reduction and internal fixation for the treatment of multiple rib fractures.

Objective: The objective of this study was to evaluate the short-term outcomes of single-port thoracoscopic rib fracture reduction and internal fixation for the treatment of multiple rib fractures.

Methods: This study included 149 patients with multiple rib fractures admitted to the Second People's Hospital Affiliated with Fujian University of Chinese Medicine between June 2021 and April 2024. The patients were divided into two groups based on the surgical method. The study group, consisting of 84 cases, underwent rib fracture reduction using a single-port thoracoscopy and internal fixation with a memory alloy reverse rib embrace device. The control group, consisting of 65 cases, underwent traditional open surgery for rib fracture internal fixation. Perioperative and follow-up data were collected and analyzed to assess incision length, total operation time, intraoperative blood loss, number of memory alloy embrasures placed, placement success rate, drainage tube placement time, time to mobilization, total hospitalization duration, total cost, preoperative and postoperative pain levels, postoperative complications, and rib CT results three months postoperatively.

Results: There was no statistically significant difference in general conditions between the study group and the control group. All 149 patients successfully completed the surgery, with 3 to 10 intrathoracic memory alloy embrace devices placed in each patient, achieving a 100% success rate. Compared to the control group, the study group showed significant improvements in incision length (3.5 ± 0.6 vs. 6.5±1.6 cm), intraoperative blood loss (92.5 ± 15.1 vs. 113 ± 18.2 ml), drainage tube placement time (75.4 ± 13.1 vs. 90.6 ± 15.4 h), mobilization time (2.9 ± 1.1 vs. 3.3 ± 1.3 days), and hospital stay (10.8 ± 2.7 vs. 12 ± 3.5 days), with differences being statistically significant (P < 0.05). In terms of preoperative Visual Analogue Scale (VAS) pain scores, the study group had a significantly lower score on the first postoperative day compared to the control group (3.9 ± 1.1 vs. 4.5 ± 1.4, P < 0.05). A follow-up CT and 3D reconstruction at 3 months post-surgery showed that all patients had securely fixed plates, with the study group demonstrating a higher rate of excellent fracture healing (94% vs. 83.1%), which was statistically significant (P < 0.05).

Conclusion: The use of a memory alloy reverse rib embrasure device for intrathoracic rib fracture fixation via single-port thoracoscopic surgery is safe and reliable. This method demonstrates a high success rate of internal fixation, excellent clinical fracture healing, and advantages such as minimal trauma, rapid recovery, and the simultaneous treatment of other intrathoracic conditions. It significantly reduces postoperative pain and enhances the quality of life.