TY - JOUR ID - 62234 TI - Rib Fracture Fixation Restores Inspiratory Volume and Peak Flow in a Full Thorax Human Cadaveric Breathing Model JO - Archives of Trauma Research JA - ATR LA - en SN - 2251-953X AU - Slobogean, Gerard P. AU - Kim, Hyunchul AU - Russell, Joseph P. AU - Stockton, David J. AU - Hsieh, Adam H. AU - O’Toole, Robert V. AD - Department of Orthopaedics, University of Maryland School of Medicine, R. Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA AD - Fischell Department of Bioengineering, Orthopaedic Mechanobiology Laboratory, University of Maryland, College Park, Maryland, USA AD - Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada Y1 - 2015 PY - 2015 VL - 4 IS - 4 SP - EP - KW - Flail chest KW - Inspiratory Volume KW - Operative Stabilization KW - peak flow KW - Rib Fixation DO - 10.5812/atr.28018 N2 - Background Multiple rib fractures cause significant pain and potential for chest wall instability. Despite an emerging trend of surgical management of flail chest injuries, there are no studies examining the effect of rib fracture fixation on respiratory function. Objectives Using a novel full thorax human cadaveric breathing model, we sought to explore the effect of flail chest injury and subsequent rib fracture fixation on respiratory outcomes. Patients and Methods We used five fresh human cadavers to generate negative breathing models in the left thorax to mimic physiologic respiration. Inspiratory volumes and peak flows were measured using a flow meter for all three chest wall states: intact chest, left-sided flail chest (segmental fractures of ribs 3 - 7), and post-fracture open reduction and internal fixation (ORIF) of the chest wall with a pre-contoured rib specific plate fixation system. Results A wide variation in the mean inspiratory volumes and peak flows were measured between specimens; however, the effect of a flail chest wall and the subsequent internal fixation of the unstable rib fractures was consistent across all samples. Compared to the intact chest wall, the inspiratory volume decreased by 40 ± 19% in the flail chest model (P = 0.04). Open reduction and internal fixation of the flail chest returned the inspiratory volume to 130 ± 71% of the intact chest volumes (P = 0.68). A similar 35 ± 19% decrease in peak flows was seen in the flail chest (P = 0.007) and this returned to 125 ± 71% of the intact chest following ORIF (P = 0.62). Conclusions Negative pressure inspiration is significantly impaired by an unstable chest wall. Restoring mechanical stability of the fractured ribs improves respiratory outcomes similar to baseline values. UR - https://archtrauma.kaums.ac.ir/article_62234.html L1 - https://archtrauma.kaums.ac.ir/article_62234_8301d31ce62c0ace6380297654dc04d4.pdf ER -