Clinical effect of thoracoscopy-based reduction and internal fixation in treatment of elderly patients with rib fracture

Objective To investigate the effects of thoracoscopy-based reduction and internal fixation in the rehabilitation process and functional recovery of elderly patients with rib fracture.

Methods Eighty-five elderly patients with rib fracture were selected as the study objects, and divided into control group (n=41, thoracotomy and internal fixation) and observation group (n=44, thoracoscopy-based reduction and internal fixation) according to different treatment plans. The surgical indexes (oxygensaturation recovery time, respiratory rate recovery time, mechanical ventilation time, hospital stay and bone healing time), pain scores, lung function indexesforced expiratory volume in one second (FEV₁), forced vital capacity (FVC) and peak expiratory flow rate (PEF), blood gas indexes arterial partial pressure of oxygenp_a(O₂) and arterial partial pressure of carbon dioxide p_a (CO₂), clinical efficacy and complication rate were compared between the two groups.

Results The blood oxygen saturation recovery time, respiratory rate recovery time, thoracic drainage tube indwelling time, hospital stay time and fracture healing time in the observation group were significantly shorter than those in the control group, and the chest tube drainage volume was significantly less than that in the control group (P < 0.05). At the 7 days after operation, visual analogue scale (VAS) score and p_a (CO₂) level in the two groups were significantly lower than before surgery, and the observation group was significantly lower than the control group (P < 0.05). At 7 days after surgery, the levels of FEV₁, FVC, PEF, FEV₁/FVC and p_a(O₂) in the two groups were significantly higher than before surgery, and the observation group was significantly higher than the control group (P < 0.05). The total effective rate of the observation group was 93.18%, which was significantly higher than 78.05% of the control group (P < 0.05). The incidence of complications in the observation group was 4.55%, which was significantly lower than 9.51% in the control group (P < 0.05).

Conclusion Thoracoscopy-based reduction and internal fixation in treatment of elderly patients with rib fracture has significant clinical efficacy, which can effectively shorten the rehabilitation process, relieve the pain of patients, and promote the recovery of lung function, with high safety.