Waseda Ryuichi, Matsumoto Isao, Tatsuzawa Yasuhiko, Iwasaki Akinori
Department of General Thoracic, Breast, and Pediatric Surgery, Fukuoka University, Fukuoka, Fukuoka, Japan.
Department of Surgery, Saiseikai Kanazawa Hospital, Kanazawa, Ishikawa, Japan.
Ann Thorac Cardiovasc Surg. 2019 Dec 20;25(6):336-339. doi: 10.5761/atcs.cr.17-00223. Epub 2018 Mar 22.
We present a case of a severe osteoporotic octogenarian who sustained serious flail chest from a traffic accident. The 3rd-9th ribs of the right chest wall were fractured. Non-operative management was unsuccessful. We performed a surgical fixation using a bio-absorbable and bio-active mini-plating set. This plating set is unsintered hydroxyapatite (u-HA) particles/poly-L-lactide (PLLA) composite osteosynthesis device commonly used for cranial, oral, and maxillofacial surgeries. The use of the u-HA/PLLA device for chest wall reconstruction has previously been reported, but no long-term results have been included. This case showed several advantages of the procedure with 4-year follow-up over other reported methods, especially in an osteoporotic elderly patient.
我们报告一例严重骨质疏松的八旬老人，因交通事故导致严重连枷胸。右胸壁第3 - 9肋骨骨折。非手术治疗未成功。我们使用生物可吸收和生物活性微型钢板固定装置进行了手术固定。该钢板固定装置是未烧结的羟基磷灰石（u-HA）颗粒/聚-L-丙交酯（PLLA）复合骨合成装置，常用于颅骨、口腔和颌面外科手术。此前已有关于使用u-HA/PLLA装置进行胸壁重建的报道，但未包括长期结果。该病例显示了该手术在4年随访中的几个优于其他报道方法的优点，尤其是在骨质疏松的老年患者中。
