The purpose of this study is to assess the outcome of a muscle sparing, minimally invasive open surgical technique for unstable ribcage injuries after trauma. The investigators will compare the results from the study participants to a historical cohort who were operated with a different surgical technique with large incisions and simultaneous thoracotomy.
This is a prospective follow-up study where the investigators aim to study patients who have undergone surgery with a muscle sparing, minimally invasive technique for unstable ribcage after trauma. The investigators plan on seeing the participants as out patients 6 months and 1 year after surgery. The results will be compared to results from a historical cohort with patients who participated in earlier studies with a different surgical method with large incisions and simultaneous thoracotomy. The investigators plan on including 50 patients since a preliminary analysis has suggested this should be enough to notice statistically significant differences between the groups.
Study Type
OBSERVATIONAL
Enrollment
100
Minimally invasive and muscle sparing surgical fixation of ribs and/or sternum in an unstable segment of the chest wall (flail chest) with titan plates or medullary nails (MatrixRib Fixation System, DepuySynthes).
Surgical fixation of ribs and/or sternum in an unstable segment of the chest wall (flail chest) with titan plates or medullary nails (MatrixRib Fixation System, DepuySynthes). Large non muscle sparing incision with simultaneous thoracotomy.
Sahlgrenska University Hospital
Gothenburg, Sweden
Vital capacity of the lungs.
Vital capacity (VC) measured with spirometry.
Time frame: One year after surgery.
Forced vital capacity of the lungs.
Forced vital capacity (VC) measured with spirometry.
Time frame: One year after surgery.
Forced expiratory volume of the lungs.
Forced expiratory volume in 1 second (FEV1) measured with spirometry.
Time frame: One year after surgery.
Forced expiratory volume percent of the lungs.
Forced expiratory volume in 1 second divided with forced vital capacity, measured with spirometry.
Time frame: One year after surgery.
Peak expiratory flow of the lungs.
Peak expiratory flow measured with spirometry.
Time frame: One year after surgery.
Disability
Degree of disability assessed with Disability Rating Index (DRI) scale ranging from 0-100 where higher scores indicate more disability.
Time frame: Six months and one year after surgery.
Physical activity
Physical activity assessed with Grimby activity scale ranging from 1-6 where 6 indicates the highest level of activity.
Time frame: Six months and one year after surgery.
Shoulder mobility
Shoulder mobility assessed with Boström index, a scale ranging from 5-30 for each shoulder where 30 represents the greatest range of movement.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: Six months and one year after surgery.
Respiratory movement
Movement of chest wall during respiration measured with Respiratory Movement Measuring Instrument (RMMI).
Time frame: Six months and one year after surgery.
Strength of respiratory muscles
Strength of respiratory muscles measured with Maximal Inspiratory Pressure (MIP) and Maximal Expiratory Pressure (MEP).
Time frame: Six months and one year after surgery.
Quality of life EQ-5D-5L
Quality of life assessed with the EuroQol (European Quality of Life) Five Dimension Five Level Scale (EQ-5D-5L). A 5-dimensional scale in which each dimension has 5 levels where 1 represents the best outcome and 5 represents the worst outcome.
Time frame: Six months and one year after surgery.
Radiological healing
Radiological signs of healing of the participants rib fractures assessed with CT scan. Fractures will be denoted as healed, partially healed or with no signs of healing.
Time frame: One year after surgery.