Feasibility of Chest Wall Reconstruction Following Major Chest Wall Trauma: A Single Center Experience

Background: Chest wall trauma with multiple rib fractures or flail segments is associated with substantial morbidity. Surgical stabilization of rib fractures (SSRF) has emerged as an effective strategy to improve respiratory mechanics, reduce pain, and shorten Intensive Care (ICU) and hospital stay. Objective: To evaluate the feasibility, safety, and short-term outcomes of chest wall reconstruction following major chest wall trauma. Patients and Methods: This retrospective study included 15 consecutive patients with major chest wall trauma managed at Menoufia University Hospital from January 2022 to December 2024. Eligible patients were 16–90 years old with ≥4 rib fractures, flail segments, or markedly depressed chest wall. Preoperative assessment included clinical and radiological evaluation. Surgical reconstruction used contoured titanium plates and locking screws, with selective rib or sternal fixation based on fracture pattern. Postoperative care included multimodal analgesia, respiratory support, chest physiotherapy, and early mobilization. Outcomes assessed were operative time, number of ribs fixed, ICU and hospital length of stay, complications, mortality, and six-month functional recovery. Results: All patients were males (19–49 years). Road traffic accidents accounted for 53.3% of cases. Patients sustained a mean of 7.3 fractured ribs, with an average of 3.2 ribs fixed. Mean operative time was 105.6 minutes. ICU and hospital stay averaged 3.3 and 10.5 days, respectively. Minor complications occurred in 2 patients (13.3%), with no hardware failure or mortality. Follow-up showed satisfactory pain control and functional improvement. Conclusion: Chest wall reconstruction is feasible and safe, achieving stable fixation, low morbidity, and favorable short-term recovery in appropriately selected trauma patients.