Long-term outcomes after removal of rib stabilization hardware in patients with blunt chest trauma.

Abstract

Purpose: The study aim was to investigate the long-term outcomes after hardware removal (HR) in patients with blunt chest trauma. We hypothesized that HR might be beneficial in indicated patients to improve patient health.

Methods: We performed a retrospective single-center study between 2017 and 2023. Descriptive statistics were used for the analysis. One study-specific follow-up visit was conducted, 28 months (range 3-72) after HR. The study-specific health survey used, consisted of four functional dimensions (mobility, self-care, usual activities, mental health) and two symptom dimensions (thoracic pain, chest tightness) which were rated on a numerical scale and compared to the status before HR in four categories (much better to worse).

Results: Of the 28 patients, the average age was 59 years (range 29-83), 12 fractures (1-39) were fixed, and 4 implants (1-11) were used. The indications for HR were persistent thoracic pain (36%), discomfort (25%), chest tightness (21%), hardware dislocation (11%) and hardware infection (7%). HR was performed 18 months (5 days-104 months) after surgery for trauma. Patients with chest tightness and infection exhibited the greatest improvement in symptoms (75%), followed by those with hardware dislocation (61%). The improvement rate in the other 2 groups was 58%. All patients who experienced chest tightness, hardware dislocation and infection were completely satisfied and would undergo HR again.

Conclusion: HR is safe and feasible, resulting in significant symptom relief and improvement in health status in approximately two-thirds of patients. In indicated patients, HR might be performed earlier and more liberally if symptoms are disabling.

Clinical trial registration number: NCT06003595 registered on July 18, 2023.