To explore the feasibility and clinical efficacy of Complete Thoracoscopic surgical stabilization of rib fractures (CTSSRF) in patients with rib fracture.

The CTSSRF cases admitted to The Third Hospital of Shijiazhuang from September 2019 to September 2021 were retrospectively collected, and the patients’operative time, thoracic drainage, pain score, internal fixation displacement and satisfaction degree of fracture reduction were analyzed for an initial analysis of the feasibility of operation and clinical effect.

A total of 18 cases of CTSSRF were completed, and the posterior rib fracture near the covering area of the scapula was all fixed under CTSSRF, including 1 case of CTSSRF and 17 cases of CTSSRF combined with conventional open surgical stabilization of rib fractures (SSRF) at other parts. A total of 45 rib fractures were fixed under CTSSRF (mean 2.5 ribs/person) and 77 ribs were fixed under conventional open SSRF (mean 4.3 ribs/person). The average operation time was 90 (50–150) min, and the thoracic drainage tube was removed 2–5 days after surgery. The thoracic drainage volume was (530.33±244.84) mL. The postoperative visual analogue scale (VAS) score was 3 (3.0–4.0), which was significantly lower than preoperative score of 7 (6.75–8.0), the difference was statistically significant (Z=1.886, P=0.002). The postoperative internal fixation displacement rate of CTSSRF is 4.44% (2/45), and the poor fixation reduction rate is 26.67% (12/45). All patients had no obvious thoracic malformations after surgery, and the incision healed well. They were followed up by telephone for 12 to 24 months. And the ability to work was recovered half a year after surgery, with no obvious symptoms of chest discomfort, and no obvious discomfort when the temperature changed and the body surface was touched, and no internal fixation was removed due to discomfort after surgery.

CTSSRF is safe and feasible, especially suitable for high posterior rib fracture near the scapula covering area. It is a beneficial supplement to traditional surgery. However, there are still some defects such as surgical difficulties, high incidence of displacement of internal fixation and poor fracture position, extensive pleural injury, and a large amount of postoperative pleural effusion, which still need to be further summarized and discussed.