TY  - JOUR
AU  - Palma, Angela De
AU  - Sollitto, Francesco
AU  - Loizzi, Domenico
AU  - Gennaro, Francesco Di
AU  - Scarascia, Daniele
AU  - Carlucci, Annalisa
AU  - Giudice, Giuseppe
AU  - Armenio, Andrea
AU  - Ludovico, Rossana
AU  - Loizzi, Michele
PY  - 2016
TI  - Chest wall stabilization and reconstruction: short and long-term results 5 years after the introduction of a new titanium plates system
JF  - Journal of Thoracic Disease; Vol 8, No 3 (March 18, 2016): Journal of Thoracic Disease
Y2  - 2016
KW  - 
N2  - 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.
UR  - https://jtd.amegroups.org/article/view/6762