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Chest wall stabilization and reconstruction: short and long-term results 5 years after the introduction of a new titanium plates system

  
@article{JTD6762,
	author = {Angela De Palma and Francesco Sollitto and Domenico Loizzi and Francesco Di Gennaro and Daniele Scarascia and Annalisa Carlucci and Giuseppe Giudice and Andrea Armenio and Rossana Ludovico and Michele Loizzi},
	title = {Chest wall stabilization and reconstruction: short and long-term results 5 years after the introduction of a new titanium plates system},
	journal = {Journal of Thoracic Disease},
	volume = {8},
	number = {3},
	year = {2016},
	keywords = {},
	abstract = {Background: We report short and long-term results with the dedicated Synthes® titanium plates system, introduced 5 years ago, for chest wall stabilization and reconstruction. 
Methods: We retrospectively analyzed (January 2010 to December 2014) 27 consecutive patients (22 males, 5 females; range 16–83 years, median age 60 years), treated with this system: primary [3] and secondary [8] chest wall tumor; flail chest [5]; multiple ribs fractures [5]; sternal dehiscence-diastasis [3]; sternal fracture [1]; sternoclavicular joint dislocation [1]; Poland syndrome [1]. Short-term results were evaluated as: operating time, post-operative morbidity, mortality, hospital stay; long-term results as: survival, plates-related morbidity, spirometric values, chest pain [measured with Verbal Rating Scale (VRS) and SF12 standard V1 questionnaire]. 
Results: Each patient received from 1 to 10 (median 2) titanium plates/splints; median operating time was 150 min (range: 115–430 min). Post-operative course: 15 patients (55.6%) uneventful, 10 (37%) minor complications, 2 (7.4%) major complications; no post-operative mortality. Median post-operative hospital stay was 13 days (range: 5–129 days). At a median follow-up of 20 months (range: 1–59 months), 21 patients (78%) were alive, 6 (22%) died. Three patients presented long-term plates-related morbidity: plates rupture [2], pin plate dislodgment [1]; two required a second surgical look. One-year from surgery median spirometric values were: FVC 3.31 L (90%), FEV1 2.46 L (78%), DLCO 20.9 mL/mmHg/min (76%). On 21 alive patients, 7 (33.3%) reported no pain (VRS score 0), 10 (47.6%) mild (score 2), 4 (19.1%) moderate (score 4), no-one severe (score >4); 15 (71.5%) reported none or mild, 6 (28.5%) moderate pain influencing quality of life. 
Conclusions: An optimal chest wall stabilization and reconstruction was achieved with the Synthes® titanium plates system, with minimal morbidity, no post-operative mortality, acceptable operating time and post-operative hospital stay. Long-term restoration of a normal respiratory function was achieved, with minimal plates-related morbidity and chest pain.},
	issn = {2077-6624},	url = {https://jtd.amegroups.org/article/view/6762}
}