Bayram ALTUNTAŞ
Türk Göğüs Kalp Damar Cerrahisi Dergisi - 2026;34(3):319-324
Background: Surgical stabilization of rib fractures (SSRF) improves outcomes in severe chest trauma. computed tomography is the gold standard for diagnosis, but real-time intraoperative localization remains a challenge. This observational study aimed to describe our single-center evaluation with perioperative ultrasonography for intraoperative localization of displaced rib fractures during SSRF. Methods: We retrospectively analyzed 16 patients with three or more displaced rib fractures who underwent SSRF between January 2020 and December 2025. All patients underwent ultrasonography in the operating room immediately prior to incision using a 4.4 MHz convex array transducer for fracture marking and incision planning. A standardized perioperative protocol was applied to all study participants to evaluate the feasibility of fracture localization. Post-discharge ultrasonography was performed as part of routine outpatient evaluation. Results: The mean postoperative hospital stay was 5.5 days. Associated thoracic injuries included pneumothorax (n=6), hemothorax (n=6), pulmonary contusion (n=2), traumatic pneumatocele (n=1) and hemopneumothorax (n=1). Perioperative ultrasonography enabled identification of displaced fracture sites and facilitated skin marking prior to incision. In all patients, cortical disruption was visualized as a step-off or discontinuity of the hyperechoic rib line using the convex probe. Postoperative complications were limited to two cases of superficial skin infection (12.5%). During follow-up, ultrasonography identified two cases (12.5%) of small, asymptomatic pleural effusions, which were subsequently confirmed by chest radiography. Conclusion: Perioperative ultrasonography appears to be a feasible adjunct for intraoperative localization of displaced rib fractures during surgical stabilization. Even with a lower-frequency convex probe, displaced fracture segments were identifiable. Larger prospective and comparative studies are required to determine its impact on operative metrics and clinical outcomes.
