Reconstructive options of the chest wall after trauma: a narrative review

Background and Objective: Trauma remains the third leading cause of death in the world and the involvement of the chest with multiple rib fractures is an aggravating factor in the patient's outcomes. We perform a review of the literature, examining the current surgical options, in order to evaluate the most effective method of restoring quickly the excellent general conditions. Methods: We carried out research of the papers in literature by performing a search on the MEDLINE database through PubMed including works from the past 10 years using the following criteria: "chest trauma AND chest wall". A total of 1,385 results were obtained and 1,108 articles were identified after the duplicates were removed. Only 214 were rated relevant after reading the full text. Key Content and Findings: There are different but still valid approaches to reconstructions. Techniques often motivated by the adaptive abilities of the operator with the instruments available and according to the different clinical needs. The surgical stabilization with titanium plates and Judet's struts allows a faster recovery of respiratory function and a lower risk of lung infections. This leads to shorter intubation times, shorter stays in intensive care and a shorter overall hospitalization. Conclusions: The main goal is the rapid recovery of the patient, respecting the anatomy and avoiding complications. Whenever possible, surgical stabilization is the preferred option. Non-rigid materials offer greater safety but titanium remains the best choice due to the possibility of customization, resistance and compatibility with parietal tissues.