Application of Titanium Mesh in the Early Treatment of Flail Chest.

Abstract

Objective: To investigate the effect of the titanium mesh on flail chest and bone healing from clinical and animal experiments. Methods: Clinical experiment: 24 patients with flail chests in our hospital from January 2020 to January 2023 were prospectively selected and divided into control and titanium mesh groups according to different treatment plans and basic data-matching principles, with 12 cases in each group. The control group was treated with conservative external fixation, and the titanium mesh group was treated with titanium mesh fixation. The clinical efficacy index, visual analog scale and blood gas indexes and hemodynamic indexes of the two groups of patients were recorded. Chest CT and pulmonary function and life quality were examined after operation. Animal experiment: The flail chest sheep were treated conservatively with a titanium mesh, and the expression of bone-healing-related proteins was detected. Results: The mechanical ventilation time, drain indwelling time, ICU observation time, and hospital time in the titanium mesh group were significantly shorter than those in the control group (p < 0.05). The PaO₂, CVP, FVC, FEV1, MVV, and life quality of the titanium mesh group were significantly better than those of the control group after operation, and the visual analog scale, PaCO₂, CI, ELWI, and the proportions of atelectasis, thoracocyllosis, and consolidation tardive after operation were significantly lower than those of the control group (p < 0.05). The expressions of BMP2, IGF-1, VEGF, and PDGFD in the rib tissue of titanium mesh sheep were higher than those of control sheep at 4 weeks after operation (p < 0.05). Conclusion: Titanium mesh is a safe and effective treatment for flail chest, which can improve pain, blood gas, hemodynamic indexes, and pulmonary function and promote fracture healing.