XXXX Implant Failure After Chest Wall Osteosynthesis.

@entity1 @entity5 @entity281 @entity397 @entity702
BACKGROUND: Our objective was to assess potential contributing factors to implant failure (displacement or @entity397 ) after @entity702 chest wall osteosynthesis. METHODS: We retrospectively reviewed the clinical data and preoperative and postoperative computed tomographic scans of @entity1 undergoing chest wall osteosynthesis with @entity702 implants: the Stratos or the Matrix Fixation System in two European departments of thoracic surgery. The indications for @entity702 chest wall osteosynthesis, the type and number of implants, the topography of the reconstruction, surgical @entity281 , and role of associated flap and mesh were assessed. RESULTS: Between January 2009 and January 2013, 54 @entity1 underwent osteosynthesis after surgical correction of chest wall deformities (n  = 25, 46.2%) or to bridge the defect after @entity5 removal (n  = 29, 53.7%). The topography of osteosynthesis was anterior (n  = 20), lateral (n  = 3), or posterior (n  = 1), an average of 1.9    0.9 implants (range, 1 to 5 implants) being used. A combined mesh restored continuity of the chest wall in 15 @entity1 , and muscle flap coverage was performed in 20. The mean follow-up time was 20.2    8.4 months (range, 3 to 48 months). Among these 54 @entity1 , 24 (44%) experienced an implant failure. Seven (29%) were symptomatic. Broken (n  = 20, 83.3%) or displaced (n  = 4, 16.7%) implants were removed with or without replacement. In @entity1 with broken or displaced implants, the mean duration without implant failure was 6.6    3.1 months (range, 1 to 12 months). There was a significant relationship between the anterior topography of osteosynthesis and implant failure (p  = 0.02). CONCLUSIONS: Long-term follow-up after chest wall osteosynthesis using @entity702 implants is required, especially in anteriorly placed implants. The high rate of implant failure at 1 year advocates for early removal whenever possible and suggests the need for improvements in design.
