Fig. 2

Schematic diagram of the reduction and fixation of rib fracture with single-operation-port complete VATS. A The distal rib of the fracture was pushed outward and upward with “peach shape” reduction forceps to achieve rib fracture reduction. B, C The puncture reduction hook penetrated the chest wall on the upper or lower rib edge at the fracture’s distal rib into the chest cavity and then rotated to hook the distal rib by pulling it upwards. The proximal end of the rib fracture was pushed outward to complete the reduction of the rib fracture combined with the “peach shape” reduction forceps. D The reverse memory alloy rib plate was delivered to the target rib with the help of the endoscopic rib plate placement instrument, which had a movable joint that moved forward and backward 45 degrees. It made the encircling arm’s tip of the reverse memory alloy rib plate pierce into the upper and lower edges of the fractured ribs and encircle the fractured ribs at the rib’s internal cortex. E A straight needle with thread was punctured 2 cm on both sides of the rib fracture line at the upper or lower edge of the rib in the thoracic cavity. The thread was pulled out through the chest wall as a traction line. The intrathoracic traction line was drawn from inside the chest along the main operating hole to the outside of the chest. The traction line bound the rib plate around the encircling arm side hole. By pulling the traction line outside the chest wall, the pre-cooled reverse memory alloy rib plate was drawn into the chest, and was placed on the target rib along the sutures pulling up. It made the tip of the encircling arm of the reverse memory alloy rib plate to pierce into the upper and lower edges of the fractured rib and F encircle the fractured ribs at the internal cortex of the rib