Preliminary Results of Rib Osteosynthesis at the Teaching Hospital Sylvanus Olympio in Lomé


Thoracic trauma
costal osteosynthesis

How to Cite

Damessane L, Rabiou S, Bignandi K, Akpoto Y, Keheou P, Alassani T, Abalo A. Preliminary Results of Rib Osteosynthesis at the Teaching Hospital Sylvanus Olympio in Lomé. ATD [Internet]. 2023 Nov. 23 [cited 2024 Jun. 25];2023. Available from:


Introduction:  Flaps and rib fractures can be life-threatening due to disruption of hematosis. In certain “many” situations, it is important to quickly restore parietal rigidity by costal osteosynthesis. The objective of our work is to report the surgical results of a first Togolese series of rib osteosynthesis performed in the context of chest trauma.
Patients and methods: We proceed by a retrospective study on a series of patients treated for severe blunt chest trauma and who underwent osteosynthesis from 2020 to 2022. Epidemiological and clinical data, in particular the radiological lesion assessment clinic, the therapeutic measures as well as the immediate operative follow-up were collected.
Results: six patients with blunt chest trauma. They were four men and two women whose mean age was 44.4 years. Five patients were admitted for polytrauma and one patient for a serious thoracic trauma. All were admitted to intensive care unit  on day 0 of the trauma. The radioclinical assessment had noted staged fractures of ribs and/or thoracic flap with an average of six affected ribs. All the patients presented pleural effusions and benefited from pleural drainage on their admission to intensive care, often after a chest X-ray or after carrying out a chest CT scan or a whole-body CT scan. The indication for rib osteosynthesis was retained on the clinical criteria, in particular the existence of a pleural effusion, the instability of the wall and the impact on hematosis, by the drop in peripheral oxygen saturation (Sp02). Despite oxygen therapy above 6 l/min for more than 4 days, and according to the results of the chest CT scan and the evolution of the patient after the implementation of the means of resuscitation. The osteosynthesis material used was “third tube” orthopedic plates molded intraoperatively in three patients, pelvic plates in one patient. The average number of plates used was 4.5 and that of Vis was 18. Two patients underwent osteosynthesis by Judet staple.
Conclusion: rib osteosynthesis contributes to a regression of symptoms, in particular chest pain, to reduce the duration of hospitalization, morbidity and mortality, and then improves the functional respiratory prognosis in the short and long term. Despite our reduced technical platform, the results are generally good, reducing the hospital stay in intensive care. This encourages the practice of surgical management of multiple rib fractures associated or not with a rib flap.


Calhoon JH, Grover FL, Trinkle JK. Chest trauma: approach and management. Clin Chest Med 1992; 13: 55–67.

Freysz M, Doussot C. Traumatismes thoraciques fermés. EMC (Elsevier Masson SAS, Paris), Médecine d’urgence, 25-200-D-10, 2007. Disponibles sur

Maloney JV, Schnutzer K, Raschke E. Paradoxical respiration and «pendelluft ». Journal of Thoracic and Cardiovascular Surgery 1961; 41: 291-298.

Jian-Peng Zhang, Lin Sun, Wei-Qiang Li, Yan-Yu Wang, Xin-Zhen Li, Yang Liu. Surgical treatment of patients with severe non-flail chest rib fractures. World J Clin Cases 2019 November 26; 7 (22): 3718-3727.

Fredric M, Pieracci, MD, MPH, Kiara Leasia, MD, Zach Bauman, DO, Evert A. Eriksson, MD et al. A multicenter, prospective, controlled clinical trial of surgical stabilization of rib fractures in patients with severe, nonflail fracture patterns (Chest Wall Injury Society NONFLAIL). J Trauma Acute Care Surg 2020 ; 88 (2) : 249-257.

Almeimoune A1, Mangane MI1, Diop Th M1, Beye SA2, Démbele AS3, KOITA S4, Coulibaly M4, Diango MD. Aspects épidémiologiques, cliniques des traumatismes liés aux accidents de la circulation routière (ACR) impliquant les motos à Bamako. RAMUR 2017 ; 22 (1) : 64-67.

Yapobi Y, Tanauh Y, Kangah M, Bouable et col. Les traumatismes thoraciques : à propos de 46 cas. Médecine d’Afrique Noire 1992 ; 39 (4) : 278-282.

Tomta K, Assenouwe S, Akala YGME et al. Management of polytrauma patients in intensive care at the Sylvanus Olympio University Hospital of Lomé (Togo). Rev. Afr. Anesthésiol. Med. Urgence 21 (2016): 2-9.

Kulshrestha P, Munshi I, Wait R. Profile of chest trauma in a level I trauma center. J. Trauma 57 (2004): 576-581.

Abdoulhamidou A, Thierno DM, Moustapha M, et al. Chest Trauma at the Emergency Department of the Gabriel Touré University Hospital Bamako, Mali. Open Journal of Emergency Medicine 9 (2021) : 18-24.

Essohanam Tabana Mouzou, Sarakawabalo Assenouwe, Damessane Lamboni, Kondo Bignandi, et al. Management of Thoracic Trauma in Intensive Care Unit in Togo: A Particular Reference to Sylvanus Olympio University Hospital of Lome. Anesthesia and Critical Care 4 (2022): 52-63.

Bulger EM, Arnerson MA, Mock CN et al. Rib fractures in the elderly. Jtrauma 2000; 48: 1040-6.

Golic DA, Svraka D, Keleman N and Petrovic S (2018) Epidural AnalgesiabWith Surgical Stabilization of Flail Chest Following Blunt Thoracic Trauma in Patients With MultipleTrauma. Front. Med.2018;(5):280.doi: 10.3389/fmed.2018.00280

Fabricant L, Ham B, Mullins R, Mayberry J. Prolonged pain and disability are common after rib fractures. Am J Surg. 2013; 205 (5) : 511–5.

Caragounis et al. Surgical treatment of multiple rib fractures and flail chest in trauma: a one-year followup study. World Journal of Emergency Surgery (2016) 11:27.

Ziegler DW, Agarwal NN. The morbidity and mortality of rib fractures. J Trauma 1994 ; 37 (6) : 975–9.

Tanaka H, Yukioka T, Yamaguti Y, Shimizi S et al. Surgical stabilization or internal pneumatic stabilization? A prospective randomized study of management of severe flail chest patients. J trauma 2002; 52 (40): 727-732.

Billè A, Okiror L, Karenovics W, Routledge T. Experience with titanium devices for rib fixation and coverage of chest wall defects. Interact CardioVasc Thorac Surg 2012 Oct 1; 15 (4): 588–95.

Ng CS, Ho AM, Lau RW, Wong RH. Chest wall reconstruction with Matrix Rib system: avoiding pitfalls. Interact Cardiovasc Thorac Surg 2014 Mar; 18 (3): 4023.

Merchant N, Onugha O. Novel extra-thoracic VATS minimally invasive technique for management of multiple rib fractures. Journal of Visualized Surgery 2018; 4: 103.

Honggang Xia, Deqing Zhu, Jing Li, Zhongyi Sun, Limin Deng, Pengzhi Zhu, Yongmin Zhang, Xuan Li and Dongbin Wang. Current status and research progress of minimally invasive surgery for flail chest (Review). Experimental and therapeutic medicine 2020; 19: 421-427.

Marasco S, Quayle M, Summerhayes R, Sutalo I and Liovic P. An assessment of outcomes with intramedullary fixation of fratured ribs. Journal of Cardiothoracic Surgery 2016 ; 11: 126 -133.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright (c) 2023 Lamboni Damessane, Sani Rabiou, Kondoh Bignandi, Yao Akpoto, Keheou Palissam , Tarek Alassani, Anani Abalo


Metrics Loading ...