Prospective Study of Video-assisted Rib Planting in Chest Wall Stabilization

Study Overview
=================
Brief Summary
-----------------
The purpose of this study is to compare the advantages and disadvantages of video-assisted rib planting and traditional internal fixation of rib fractures in chest wall stabilization. The investigators design a new surgical method of video-assisted thoracoscopic surgery for rib fractures, evaluate the advantages and disadvantages of the new surgical techniques with a prospective study.

Official Title
-----------------
Prospective Study of Video-assisted Rib Planting in Chest Wall Stabilization

Conditions
-----------------
Rib Fractures, Rib Fracture Multiple

Intervention / Treatment
-----------------
* Procedure: video-assisted rib planting


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: -≥3 unilateral rib displacement fractures 18-70 years old ASA score I-II Preoperative arterial oxygen partial pressure >60mmHg Carbon dioxide partial pressure <50mmHg Exclusion Criteria: The distance from the broken end of the posterior rib fracture to the spine is less than 2cm Airway stenosis Abnormal coagulation system History of peptic ulcer or bleeding History of allergy to anesthesia related drugs History of asthma or chronic obstructive pulmonary emphysema Pregnant women

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: video-assisted rib planting<br> | Procedure: video-assisted rib planting<br>* Give the patient intercostal nerve block and laryngeal mask anesthesia, after that, put the patient in lateral position. Make a 4-6cm posterolateral incision along the lower edge of the scapula，sever latissimus dorsi and serratus anterior and reach the rib surface. Lift the scapula with the abdominal retractor (or xiphoid retractor), Free adhesion tissue inside the scapula and put in the thoracoscopic lens. Free the tissue of the upper and lower edges of the ribs carefully, reset ribs and insert rib plate, which is fixed by 90° electric drill and locking screw.<br>* Other names: video-assisted thoracoscopic surgery for rib fractures;|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The pain score after operation | The investigators evaluate and record the patients' pain score after operation by visual analog scale (VAS)，which is used to evaluate pain scores 6h,12h,and 24h after the operation. 0-10 is used to represent different degrees of pain, 0 is painless and 10 is severe pain. The grading criteria of pain were: 0: no pain; 1-3: mild pain; 4-6: moderate pain; 7-10: severe pain. | 6 hours after operation | 
| The pain score after operation | The investigators evaluate and record the patients' pain score after operation by visual analog scale (VAS). 0-10 is used to represent different degrees of pain, 0 is painless and 10 is severe pain. The grading criteria of pain were: 0: no pain; 1-3: mild pain; 4-6: moderate pain; 7-10: severe pain. | 12 hours after operation | 
| The pain score after operation | The investigators evaluate and record the patients' pain score after operation by visual analog scale (VAS). 0-10 is used to represent different degrees of pain, 0 is painless and 10 is severe pain. The grading criteria of pain were: 0: no pain; 1-3: mild pain; 4-6: moderate pain; 7-10: severe pain. | 24 hours after operation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The postoperative drainage | The investigators record the postoperative drainage of patients.The drainage of chest catheter or negative pressure ball was recorded by the nurse every day after surgery. Less postoperative drainage means faster recovery and shorter discharge times. | 7 days at most | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
internal fixation, video-assisted, chest wall stabilization, prospective study