Academic Journal
Hybrid versus single internal fixation strategies in minimally invasive surgery for multiple rib fractures: a retrospective comparative analysis.
| Τίτλος: | Hybrid versus single internal fixation strategies in minimally invasive surgery for multiple rib fractures: a retrospective comparative analysis. |
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| Συγγραφείς: | Liang B; The Fifth Affiliated Hospital, Southern Medical University, 566 Congcheng Avenue, Conghua District, Guangzhou, China., Zhang T; The Fifth Affiliated Hospital, Southern Medical University, 566 Congcheng Avenue, Conghua District, Guangzhou, China., Hou M; Shuren International College, Shenyang Medical College, No. 146, Huanghe North Street, Shenyang City, Liaoning Province, China., Liu Y; Shuren International College, Shenyang Medical College, No. 146, Huanghe North Street, Shenyang City, Liaoning Province, China. lye9901@163.com., Cai Q; The Fifth Affiliated Hospital, Southern Medical University, 566 Congcheng Avenue, Conghua District, Guangzhou, China. cqy008cqy@163.com. |
| Πηγή: | European journal of orthopaedic surgery & traumatology : orthopedie traumatologie [Eur J Orthop Surg Traumatol] 2026 Jul 06; Vol. 36 (1). Date of Electronic Publication: 2026 Jul 06. |
| Τύπος έκδοσης: | Journal Article; Comparative Study; Observational Study |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Springer-Verlag France Country of Publication: France NLM ID: 9518037 Publication Model: Electronic Cited Medium: Internet ISSN: 1432-1068 (Electronic) Linking ISSN: 16338065 NLM ISO Abbreviation: Eur J Orthop Surg Traumatol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Paris : Springer-Verlag France |
| Ιατρικοί όροι (MeSH): | Rib Fractures*/surgery , Fracture Fixation, Internal*/methods , Fracture Fixation, Internal*/instrumentation , Fracture Fixation, Internal*/adverse effects , Minimally Invasive Surgical Procedures*/methods , Minimally Invasive Surgical Procedures*/adverse effects , Fractures, Multiple*/surgery, Flail Chest/surgery ; Flail Chest/etiology ; Humans ; Retrospective Studies ; Female ; Male ; Middle Aged ; Aged ; Bone Plates ; Feasibility Studies ; Operative Time ; Adult |
| Περίληψη: | Background: Surgical stabilization of rib fractures typically employs a single type of internal fixation material. While this "Single Strategy" offers the advantage of procedural consistency and facilitates a rapid learning curve for surgeons, it often fails to address the heterogeneity of multiple rib fractures (MRF). Factors such as fracture location, segment length, degree of comminution, and associated intrathoracic visceral injuries frequently render a single material insufficient for all fracture types within a single patient. Consequently, we adopted a clinical approach utilizing multiple fixation materials tailored to specific fracture characteristics. To date, systematic implementation of such a "Hybrid Fixation Strategy" has not been widely reported. This study aims to evaluate the safety and feasibility of this multi-material approach in patients with MRF. Methods: A retrospective, controlled, observational study was conducted on patients with MRF and flail chest treated between 2020 and 2024. A total of 316 patients were included and stratified into two groups. The Hybrid Group (n = 128) consisted of consecutive patients treated with a combination of at least two types of internal fixation materials (specifically locking plates and rib clamps) based on anatomical requirements. The Single Group (n = 188) was treated using a single fixation material. Perioperative efficiency, safety profiles, and clinical outcomes were compared to assess feasibility. Results: The Hybrid Group demonstrated superior feasibility and efficiency, with significantly shorter operative times (94.72 ± 15.46 vs. 147.53 ± 31.04 min, P < 0.001) and reduced intraoperative blood loss (213.40 ± 83.19 vs. 298.60 ± 115.96 mL, P < 0.001) compared to the Single Group. Regarding safety, there was no significant difference in the overall incidence of postoperative complications between the two groups (P > 0.05). Additionally, patients in the Hybrid Group achieved earlier ambulation (1.16 ± 0.39 vs. 2.44 ± 1.13 days, P < 0.001), indicating enhanced postoperative recovery. Conclusion: The application of multiple internal fixation materials (Hybrid Strategy) is a safe and feasible technique for managing complex MRF. By addressing the limitations of single-material fixation through site-specific adaptation, this strategy improves surgical efficiency and stability without compromising safety. While these results are promising, further studies with larger sample sizes are warranted to validate these findings. (© 2026. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.) |
| Competing Interests: | Declarations. Conflict of interest: The authors declare no competing interests. Ethics approval and consent to participate: The study was conducted in accordance with the Declaration of Helsinki and was approved by the Institutional Ethics Committee (Approval No.: blinded for peer review; Date of approval: September 15, 2025). Patient consent was waived due to the retrospective nature of this study, and the analysis used anonymous clinical data. Consent for publication: Not applicable. |
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| Grant Information: | YZ2022ZX08 President Foundation of The Fifth Affiliated Hospital, Southern Medical University; YZ2022ZX10 President Foundation of The Fifth Affiliated Hospital, Southern Medical University; 2024QC-A1018 Clinical Research Special Fund of the Guangdong Medical Association; 2024QC-A1017 Clinical Research Special Fund of the Guangdong Medical Association |
| Contributed Indexing: | Keywords: Hybrid fixation; Internal fixation materials; Minimally invasive surgery; Multiple rib fractures; Safety and feasibility |
| Entry Date(s): | Date Created: 20260706 Date Completed: 20260706 Latest Revision: 20260717 |
| Update Code: | 20260718 |
| DOI: | 10.1007/s00590-026-04762-6 |
| PMID: | 42405978 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1432-1068 |
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| DOI: | 10.1007/s00590-026-04762-6 |