Prospective Follow up of Minimally Invasive Chest Wall Surgery After Trauma
A Prospective Follow-up of Patients Treated With Muscle Sparing, Minimally Invasive Open Surgical Technique for Unstable Chest Wall After Trauma
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Contacts and Locations
Study Locations
-
-
-
Gothenburg, Sweden
- Sahlgrenska University Hospital
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Patients with chest wall trauma who underwent surgical stabilisation for unstable chest wall using a minimally invasive, muscle sparing technique without thoracotomy or thoracoscopy no more than 6 months prior to inclusion.
Exclusion Criteria:
- Severe head injury (Abbreviated Injury score (AIS) >3)
- Spinal injury
- Neurological or musculoskeletal disease affecting chest wall mobility
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Minimally invasive
Patients who underwent surgery with a muscle sparing, minimally invasive technique for unstable chest wall after trauma.
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Minimally invasive and muscle sparing surgical fixation of ribs and/or sternum in an unstable segment of the chest wall (flail chest) with titan plates or medullary nails (MatrixRib Fixation System, DepuySynthes).
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Historical control
Patients who underwent surgery with large incisions and simultaneous thoracotomy for unstable chest wall after trauma.
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Surgical fixation of ribs and/or sternum in an unstable segment of the chest wall (flail chest) with titan plates or medullary nails (MatrixRib Fixation System, DepuySynthes).
Large non muscle sparing incision with simultaneous thoracotomy.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Vital capacity of the lungs.
Time Frame: One year after surgery.
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Vital capacity (VC) measured with spirometry.
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One year after surgery.
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Forced vital capacity of the lungs.
Time Frame: One year after surgery.
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Forced vital capacity (VC) measured with spirometry.
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One year after surgery.
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Forced expiratory volume of the lungs.
Time Frame: One year after surgery.
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Forced expiratory volume in 1 second (FEV1) measured with spirometry.
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One year after surgery.
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Forced expiratory volume percent of the lungs.
Time Frame: One year after surgery.
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Forced expiratory volume in 1 second divided with forced vital capacity, measured with spirometry.
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One year after surgery.
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Peak expiratory flow of the lungs.
Time Frame: One year after surgery.
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Peak expiratory flow measured with spirometry.
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One year after surgery.
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Disability
Time Frame: Six months and one year after surgery.
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Degree of disability assessed with Disability Rating Index (DRI) scale ranging from 0-100 where higher scores indicate more disability.
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Six months and one year after surgery.
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Physical activity
Time Frame: Six months and one year after surgery.
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Physical activity assessed with Grimby activity scale ranging from 1-6 where 6 indicates the highest level of activity.
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Six months and one year after surgery.
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Shoulder mobility
Time Frame: Six months and one year after surgery.
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Shoulder mobility assessed with Boström index, a scale ranging from 5-30 for each shoulder where 30 represents the greatest range of movement.
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Six months and one year after surgery.
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Respiratory movement
Time Frame: Six months and one year after surgery.
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Movement of chest wall during respiration measured with Respiratory Movement Measuring Instrument (RMMI).
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Six months and one year after surgery.
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Strength of respiratory muscles
Time Frame: Six months and one year after surgery.
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Strength of respiratory muscles measured with Maximal Inspiratory Pressure (MIP) and Maximal Expiratory Pressure (MEP).
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Six months and one year after surgery.
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Quality of life EQ-5D-5L
Time Frame: Six months and one year after surgery.
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Quality of life assessed with the EuroQol (European Quality of Life) Five Dimension Five Level Scale (EQ-5D-5L).
A 5-dimensional scale in which each dimension has 5 levels where 1 represents the best outcome and 5 represents the worst outcome.
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Six months and one year after surgery.
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Radiological healing
Time Frame: One year after surgery.
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Radiological signs of healing of the participants rib fractures assessed with CT scan.
Fractures will be denoted as healed, partially healed or with no signs of healing.
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One year after surgery.
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Erik Westin, MD, Sahlgrenska University Hospital
Publications and helpful links
General Publications
- Tanaka H, Yukioka T, Yamaguti Y, Shimizu S, Goto H, Matsuda H, Shimazaki S. Surgical stabilization of internal pneumatic stabilization? A prospective randomized study of management of severe flail chest patients. J Trauma. 2002 Apr;52(4):727-32; discussion 732. doi: 10.1097/00005373-200204000-00020.
- Granetzny A, Abd El-Aal M, Emam E, Shalaby A, Boseila A. Surgical versus conservative treatment of flail chest. Evaluation of the pulmonary status. Interact Cardiovasc Thorac Surg. 2005 Dec;4(6):583-7. doi: 10.1510/icvts.2005.111807. Epub 2005 Sep 15.
- Bemelman M, van Baal M, Yuan JZ, Leenen L. The Role of Minimally Invasive Plate Osteosynthesis in Rib Fixation: A Review. Korean J Thorac Cardiovasc Surg. 2016 Feb;49(1):1-8. doi: 10.5090/kjtcs.2016.49.1.1. Epub 2016 Feb 5.
- Caragounis EC, Fagevik Olsen M, Pazooki D, Granhed H. Surgical treatment of multiple rib fractures and flail chest in trauma: a one-year follow-up study. World J Emerg Surg. 2016 Jun 14;11:27. doi: 10.1186/s13017-016-0085-2. eCollection 2016.
- Granhed HP, Pazooki D. A feasibility study of 60 consecutive patients operated for unstable thoracic cage. J Trauma Manag Outcomes. 2014 Dec 30;8(1):20. doi: 10.1186/s13032-014-0020-z. eCollection 2014.
- Marasco SF, Davies AR, Cooper J, Varma D, Bennett V, Nevill R, Lee G, Bailey M, Fitzgerald M. Prospective randomized controlled trial of operative rib fixation in traumatic flail chest. J Am Coll Surg. 2013 May;216(5):924-32. doi: 10.1016/j.jamcollsurg.2012.12.024. Epub 2013 Feb 13.
- Westin EO, Olsen MF, Caragounis EC. Comparison of long-term outcome between muscle sparing and non-muscle sparing surgical techniques in rib plating. Eur J Trauma Emerg Surg. 2025 May 20;51(1):212. doi: 10.1007/s00068-025-02881-z.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- FoU-274457
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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