3D volume rendered Computed Tomography application for follow up fracture healing and volume measurements pre and post SRF

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Author(s)
Campbell, Don
Arnold, Nicholas
Wake, Elizabeth
Grieve, John
Provenzano, Sylvio
Wullschleger, Martin
Patel, Bhavik
Year published
2021
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BACKGROUND: Surgical rib fixation [SRF] is being used increasingly in trauma centres for stabilization of chest wall injuries, in line with new and evolving surgical techniques. Our institution has developed a pathway for the management of chest wall injuries and SRF, which includes a follow up low volume, non-contrast Computed Tomography (CT) scan at 12 months. METHODS: This study was a single centre retrospective study was conducted on 25 consecutive patients who underwent SRF between February 2019 to February 2020. All CT measurements were done by a CT radiographer under the supervision of a board-certified radiologist ...
View more >BACKGROUND: Surgical rib fixation [SRF] is being used increasingly in trauma centres for stabilization of chest wall injuries, in line with new and evolving surgical techniques. Our institution has developed a pathway for the management of chest wall injuries and SRF, which includes a follow up low volume, non-contrast Computed Tomography (CT) scan at 12 months. METHODS: This study was a single centre retrospective study was conducted on 25 consecutive patients who underwent SRF between February 2019 to February 2020. All CT measurements were done by a CT radiographer under the supervision of a board-certified radiologist and included the use of 3DVR images. RESULTS: There were no patients with SRF who experienced hardware failure at 12 months in either flail or non-flail groups. For fractured ribs treated with SRF, complete or partial union occurred in 75/76 [98.7%] of ribs plated. The median ratio for improvement in lung volumes was 1.71 for flail SRF and 1.69 for non-flail SRF in our study. CONCLUSION: 3DVR CT at 12 months post SRF showed good alignment [no hardware failure] and fracture healing of fixed ribs in both flail and non-flail groups. Lung volumes also improved pre and post SRF for both flail and non-flail patients. More studies are needed to define how the pattern of rib fracture healing of fixed and non-fixed ribs affects lung volumes. LEVEL OF EVIDENCE: Level IIIStudy TypePrognostic Original Study.
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View more >BACKGROUND: Surgical rib fixation [SRF] is being used increasingly in trauma centres for stabilization of chest wall injuries, in line with new and evolving surgical techniques. Our institution has developed a pathway for the management of chest wall injuries and SRF, which includes a follow up low volume, non-contrast Computed Tomography (CT) scan at 12 months. METHODS: This study was a single centre retrospective study was conducted on 25 consecutive patients who underwent SRF between February 2019 to February 2020. All CT measurements were done by a CT radiographer under the supervision of a board-certified radiologist and included the use of 3DVR images. RESULTS: There were no patients with SRF who experienced hardware failure at 12 months in either flail or non-flail groups. For fractured ribs treated with SRF, complete or partial union occurred in 75/76 [98.7%] of ribs plated. The median ratio for improvement in lung volumes was 1.71 for flail SRF and 1.69 for non-flail SRF in our study. CONCLUSION: 3DVR CT at 12 months post SRF showed good alignment [no hardware failure] and fracture healing of fixed ribs in both flail and non-flail groups. Lung volumes also improved pre and post SRF for both flail and non-flail patients. More studies are needed to define how the pattern of rib fracture healing of fixed and non-fixed ribs affects lung volumes. LEVEL OF EVIDENCE: Level IIIStudy TypePrognostic Original Study.
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Journal Title
Journal of Trauma and Acute Care Surgery
Copyright Statement
© 2021 Lippincott Williams & Wilkins. This is a non-final version of an article published in final form in Journal of Trauma and Acute Care Surgery, 2021. Reproduced in accordance with the copyright policy of the publisher. Please refer to the journal link for access to the definitive, published version.
Subject
Cardiovascular medicine and haematology
Clinical sciences