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Open, randomized, parallel controlled prospective clinical study design was used in this study.Subjects were patients with 2-4 displaced non-flail rib fractures.Operation group (Group 1) : minimally invasive internal fixation operation group under spontaneous breathing anesthesia.In the operation group of minimally invasive internal fixation under autonomic respiratory anesthesia, the fracture was determined preoperatively by chest CT+ three-dimensional reconstruction of the ribs, and the optimal incision location was determined. The fracture was exposed through as many small incisions as possible, and fixed with titanium plate or clon-type plate. During the operation, the autonomic respiratory anesthesia and paraviral nerve block technology was adopted.In the conservative group (group 2), routine treatment measures such as analgesia and chest strap fixed were adopted.The purpose of this study was to evaluate the safety, feasibility, and efficacy of minimally invasive and conservative treatment for rib fractures with different Numbers of displaced ends.
An open, randomized, parallel controlled prospective clinical study design type was used in this study. Subjects were patients with two to four displaced non-flail chest fractures of the ribs. Operation group (Group 1) : minimally invasive internal fixation operation group under spontaneous breathing anesthesia. In the operation group of minimally invasive internal fixation under autonomic respiratory anesthesia, the fracture was determined preoperatively by chest CT+ three-dimensional reconstruction of the ribs, and the optimal incision location was determined. The fracture was exposed through as many small incisions as possible, and fixed with titanium plate or clon-type plate. During the operation, the autonomic respiratory anesthesia and paraviral nerve block technology was adopted. In the conservative group (group 2), routine treatment measures such as analgesia, hemostasis and chest band fixation were adopted. The effects of the two treatments on lung function, pain index, complications and QoL were evaluated. It provides theoretical basis for the treatment of rib fracture
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| surgical treatment | Experimental | Minimally invasive internal fixation under spontaneous respiratory anesthesia and analgesic treatment and chest strap fixation |
|
| Conservative treatment | Experimental | analgesic treatment and chest strap fixation |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| surgical treatment | Procedure | surgical treatment and Conservative treatment |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage improvement of lung function FEV1(Forced expiratory volume in one second) | FEV1(Forced expiratory volume in one second),FEV1% :percentage of the expected value | FEV1%(One week after treatment)-FEV1%(Admitted) |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage improvement of lung function FVC | FVC(forced vital capacity),FVC%:percentage of the expected value | FVC%(One week after treatment)-FVC%(Admitted) |
| Percentage improvement of lung function PEF |
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Inclusion Criteria:
Exclusion Criteria:
A history of asthma or chronic obstructive emphysema
8. Women during pregnancy
9. Flail chest
10. Combined with severe craniocerebral trauma and external abdominal injuries
11. Recent use of clopidogrel, warfarin and aspirin seriously affects blood clotting
12. Self-administered analgesics after injury
13.Massive hemopneumothorax requires emergency surgery
14. Patients who cannot tolerate surgery
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yang Li, PHD | Contact | 13122109923 | drliyang1991@163.com |
| Name | Affiliation | Role |
|---|---|---|
| Yi Yang, PHD | Shanghai 6th People's Hospital | Study Director |
| Zongli Gao, PHD | Shanghai 6th People's Hospital | Study Chair |
| Yonghong Zhao, PHD |
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The data will not be Shared with other researchers
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| ID | Term |
|---|---|
| D013898 | Thoracic Injuries |
| D012253 | Rib Fractures |
| ID | Term |
|---|---|
| D014947 | Wounds and Injuries |
| D050723 | Fractures, Bone |
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| ID | Term |
|---|---|
| D013514 | Surgical Procedures, Operative |
| D000072700 | Conservative Treatment |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
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| Conservative treatment |
| Procedure |
Conservative treatment |
|
PEF(peak expiratory flow ),PEF%:percentage of the expected value
| PEF%(One week after treatment)-PEF%(Admitted) |
| Pain index | visual analogue scale,VAS(0-10)0:no pain;10:severe pain | Admitted;One week after treatment;One month after treatment;Three month after treatment;Half a year;One year |
| Pleural effusion | Measured by chest CT | Admitted;One week after treatment;One month after treatment;Three month after treatment;Half a year;One year |
| Mortality rate | Deaths associated with this study | Admitted;One week after treatment;One month after treatment;Three month after treatment;Half a year;One year |
| Length of hospital stay | Length of hospital stay | Admitted;One week after treatment;One month after treatment;Three month after treatment;Half a year;One year |
| Cost of treatment | Sum of all treatment costs | One year |
| Chronic pain | Pain lasting more than three months(It is suggested in the related article that pain lasting more than 3 months is chronic pain)visual analogue scale,VAS(0-10)0:no pain;10:severe pain | Three month after treatment;Half a year;One year |
| Quality of Life score | The Barthel index of ADL | One week after treatment;One month after treatment;Three month after treatment;Half a year;One year |
| Time to resume routine work | Time to resume routine work | One week after treatment;One month after treatment;Three month after treatment;Half a year;One year |
| Duration of analgesic medication | Duration of analgesic medication | intraoperative;One week after treatment;One month after treatment;Three month after treatment;Half a year;One year |
| Shanghai 6th People's Hospital |
| Study Chair |
| Weiming Wu, PHD | Shanghai 6th People's Hospital | Study Chair |
| Weigang Zhao, PHD | Shanghai 6th People's Hospital | Study Chair |
| Tiancheng Zhao, PHD | Shanghai 6th People's Hospital | Study Chair |
| Xiang Guo, PHD | Shanghai 6th People's Hospital | Study Chair |
| Lei Wang, PHD | Shanghai 6th People's Hospital | Study Chair |
| Weiwei He, PHD | Shanghai 6th People's Hospital | Study Chair |