Plating versus wiring for fixation of traumatic rib and sternal fractures

Abstract

Background

The fracture of ribs is a common injury presenting to trauma centers and hospitals. Along the years, a lot of methods have been introduced to stabilize the rib and sternal fractures, as most of studies reported that the treatment of these cases is warranted. In spite of the large number of methods for fixation introduced; no definitive method has been presented yet.

Methods

From July 2015 to November 2016, the data of 30 patients with rib or sternal fractures or both who fulfilled the inclusion criteria were collected prospectively. Those patients were assigned into two groups; (group A) the fractures were fixed by plates and (group B) were fixed by stainless steel wires. The choice of method of fixation depended on surgeon's experience. The variables evaluated included stability of chest wall, intensive care unit stay, hospital stay and ventilator days.

Results

The chest wall stability in (group A) was achieved in 100% of the patients, while in (group B) it was achieved in 60% of patients. Intensive care unit stay for group A was 9 ± 4.37 days and for group B 13.8 ± 7.61 (p = 0.031). Hospital stay for group A was 11.6 ± 5.27 days and for group B 17.1 ± 6.77 (p = 0.021). Ventilator days for (group A) were 6.38 ± 3.83 days, while in (group B) 10.3 ± 8.82days, however this difference was statistically insignificant (p = 0.129).

Conclusions

Plating of rib and sternal fractures had better outcome than wiring, regarding better chest wall stability and restoration of chest contour; also it had shorter intensive care unit, hospital and ventilator days.