Objective To investigate the clinical effect of single-port thoracoscopy combined with internal fixation in the treatment of multiple rib fractures with hemopneumothorax.

Methods A total of 44 patients with multiple rib fractures and pneumothorax were selected from April 2016 to April 2019. Single-port thoracoscopic exploration and pulmonary repair were performed within 72 h after the injury, rib embracing bone plate fixation was performed after laparoscopic positioning of rib fractures.

Results Thirteen patients with pulmonary contusion and hemorrhage underwent single-port thoracoscopic pulmonary repair, 26 patients with intercostal and parietal pleural hemorrhage underwent endoscopic hemostasis, and 5 patients underwent single-port thoracoscopic thoracic exploration. The mean interval time was (43.71±11.82) h from fracture to surgery. The average fixation time was (63.48±17.22) min, intraoperative blood loss was (70.11±19.38) mL, and postoperative drainage was (162.75±20.60) mL. The mean pain assessment score was (4.0±1.3) on day 1 and (2.8±0.8) on day 5. The first time to get out of bed after surgery was (2.1±1.1) d, the time to remove the thoracic catheter after surgery was (4.7±1.8) d after surgery, and the length of stay was (9.61±2.08) d. The wound infection occurred in 1 patient after the operation and was healed after multiple dressing changes. The wound redness and swelling occurred in 4 cases, which may be suturing reaction and subsided after suture was removed. There were 4 cases of atelectasis and 4 cases of pulmonary infection, and patients gradually improved after expectorant atomization treatment. There were 9 cases of pleural effusion, all of which was a small amount of effusion. The chest X-ray or CT examination one month after the operation showed that the effusion disappeared. Sixteen patients were cured and 28 cases were effectively treated, and the fracture healing time was (9.7±1.4) weeks. All patients were followed up for 3-6 months after the operation, and the imaging results indicated good rib alignment, callus formation, and good healing. No loosening or fracture of the rib bone plate was found in all the patients.

Conclusions Single-port thoracoscopy combined with internal fixation has the advantages of minimal invasion, mild pain, and accurate clinical effect for the treatment of multiple rib fractures with hemopneumothorax. It is recommended that early and timely operation should be performed after injury, so as improve the respiratory and circulatory function of patients, and the method might be as first choice for the treatment of multiple rib fractures combined with hemopneumothorax.