Svec Maria B, Bachmann Helga, Hojski Aljaz, Macharia-Nimietz Eric F, Dackam Sandrine V C, Lardinois Didier
Department of Thoracic Surgery, University Hospital Basel, Spitalstrasse 21, Basel, 4031, Switzerland.
Eur J Trauma Emerg Surg. 2025 Apr 29;51(1):187. doi: 10.1007/s00068-025-02858-y.
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.
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).
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.
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.
NCT06003595 registered on July 18, 2023.
本研究旨在调查钝性胸部创伤患者取出内固定装置（HR）后的长期疗效。我们假设，对于符合指征的患者，HR可能有利于改善其健康状况。
我们在2017年至2023年期间进行了一项回顾性单中心研究。采用描述性统计进行分析。在HR后28个月（范围3 - 72个月）进行了一次特定研究的随访。所使用的特定研究健康调查包括四个功能维度（活动能力、自我护理、日常活动、心理健康）和两个症状维度（胸痛、胸闷），这些维度采用数字评分，并与HR前的状况在四个类别（明显改善到恶化）中进行比较。
28例患者中，平均年龄为59岁（范围29 - 83岁），固定了12处骨折（1 - 39处），使用了4个植入物（1 - 11个）。HR的指征包括持续性胸痛（36%）、不适（25%）、胸闷（21%）、内固定装置移位（11%）和内固定装置感染（7%）。HR在创伤手术后18个月（5天 - 104个月）进行。胸闷和感染患者的症状改善最为明显（75%），其次是内固定装置移位患者（61%）。其他两组的改善率为58%。所有经历胸闷、内固定装置移位和感染的患者都完全满意，并愿意再次接受HR。
HR是安全可行的，约三分之二的患者症状得到显著缓解，健康状况得到改善。对于符合指征的患者，如果症状严重影响生活，HR可以更早、更广泛地进行。
2023年7月18日注册的NCT06003595 。
