Fraturas de esterno em uma unidade de tratamento intensivo especializada em trauma

Pereira, Leonardo Dantas da Silva; Bassi, Estêvão; Tomazini, Bruno Martins; Jesus, Vinicius Luiz Menezes; Tierno, Paulo Fernando Guimarães Morando Marzocchi; Novo, Fernando da Costa Ferreira; Malbouisson, Luíz Marcelo Sá; Utiyama, Edivaldo Massazo

doi:10.1590/0100-6991e-20192059

Cited by 5 publications

(5 citation statements)

References 12 publications

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“…The CT results, added to the refractory pain presented by the patient, as well as the clinically favorable condition, led to the choice of a surgical approach, with the use of plates and screws to stabilize the fractured area and functional recovery (Akgul Ozmen;Onat;Aycicek, 2017;Kalberer et al, 2020;Mongenstern et al, 2016;Van de Wall et al, 2020). A titanium plate was fixed, with a satisfactory result for the procedure, with no complications for the patient (Kalberer et al, 2020;Pereira et al, 2019). The adaptation to the use of transverse plates proved to be efficient, as well as limited perforation, resulting in the patient being discharged during a regular recovery period, without complications or adversities linked to the procedure.…”

Section: Discussionmentioning

confidence: 99%

“…If cardiac or pulmonary lesions are present, the surgical approach must be interdisciplinary, with attention to obtaining hemodynamic stability prior to sternal fixation. When well indicated, surgical fixation of the sternum brings benefits to the patient, such as easier weaning from mechanical ventilation (Kalberer et al, 2020;Pereira et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

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Sternal Fracture Due to Blunt Trauma

Silva,

Oliveira,

Gonçalves

et al. 2024

JHS

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Sternal fractures caused by blunt trauma are uncommon, complex, and have the potential to affect soft tissues and vital organs. Non-surgical, conservative treatment is typically preferred, but there are instances where surgery becomes necessary, especially in cases of instability, overlapping fractures, respiratory failure, persistent pain, and cardiac or vascular injuries, among others. This article aims to present a patient case involving a sternal fracture from closed chest trauma, treated with a modified surgical fixation technique at the Lourenço Jorge Municipal Hospital in Rio de Janeiro, Brazil. This retrospective study is based on a review of medical records, patient interviews, surgical reports, and literature review. The patient, a 57-year-old male, was admitted to the hospital following a fall from a 6-meter-high scaffold. He was diagnosed with a transverse fracture in the sternum accompanied by a laminar hemothorax, but no other injuries. He underwent successful surgery involving the placement of two transverse titanium plates at the fracture site, with limited screw penetration, leading to a complicationfree recovery and regular discharge after 16 days. The study concludes that the surgical technique used was safe and effective, with the patient recovering within the expected timeframe. It emphasizes the importance of thorough pre-operative patient assessment and careful surgical planning, supported by imaging techniques for enhanced precision.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sternal Fracture Due to Blunt Trauma

Silva,

Oliveira,

Gonçalves

et al. 2024

JHS

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“…The majority of thoracic injuries (80%) are represented by pneumothorax, hemothorax and hemo-pneumothorax, which are resolved, in most cases, by TTUS, associated or not with analgesia and ventilatory therapy. There are few cases (10% to 30%) that require more complex procedures, such as thoracotomy, especially when there is massive hemothorax, hemopericardium (cardiac tamponade), hemoptysis, mediastinal widening, respiratory failure due to intense air leakage through the drain, chest pain, and marked hypotension 3 , 4 , 6 , 11 , 12 .…”

Section: Discussionmentioning

confidence: 99%

Clinical-epidemiological evaluation of victims of thoracic trauma in a reference hospital in Aracaju-SE

Gonçalves,

Rezende,

Cunha

et al. 2023

Rev. Col. Bras. Cir.

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Introduction: thoracic trauma is defined as anything that involves the rib cage, the musculoskeletal framework that houses the heart, lungs, pleurae and mediastinal structures. It can be superficial or immediately lifethreatening for victims. In Brazil, most assistance is due to urban violence. Objective: evaluate the clinical and epidemiological aspect of patients who are victims of thoracic trauma treated at Hospital de Urgência de Sergipe, Aracaju/SE, Brazil. Method: cross-sectional, observational and prospective study, carried out for eleven months, with 100 polytraumatized patients. A semi-structured form was applied, and the data were systematized, analyzed and statistically tested considering a 5% margin of error. Results: 85% of the patients were male, with a mean age of 39.3 and an age range of 30 to 49 years; 57% of them had incomplete primary education, 70% had a family income of up to 2 minimum wages and 41% were from Greater Aracaju. As for the mechanism of trauma, 33% were car-related, with blunt trauma as the main mechanism, and rib fractures as the main consequence. Among penetrating injuries, CWI (26%) and GSW (21%) were the most prevalent, with hemothorax being the main consequence. Most patients underwent thoracostomy (59%). Conclusion: the profile found was of young men, victims of urban violence. The thoracostomy was resolving in most cases and should be instituted promptly when necessary. A smaller number of patients may require thoracotomy, especially in the presence of hemodynamic instability.

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“…A maior parte das lesões torácicas (80%) são representadas pelo pneumotórax, hemotórax e hemopneumotórax, sendo elas resolvidas, na maior parte das vezes, pela TDPF, associada ou não à analgesia e terapia ventilatória. São poucos os casos (10% a 30%) que necessitam de procedimentos mais complexos, como a toracotomia, principalmente quando há a presença de hemotórax maciço, hemopericárdio (tamponamento cardíaco), hemoptise, alargamento mediastinal, insuficiência respiratória por intenso escape aéreo pelo dreno torácico e hipotensão acentuada 3,4,6,11,12 .…”

Section: Discussionunclassified

Avaliação clínico-epidemiológica dos pacientes vítimas de trauma torácico em um hospital de referência de Aracaju-SE

Gonçalves,

Rezende,

Cunha

et al. 2023

Rev. Col. Bras. Cir.

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RESUMO Introdução: o trauma torácico é definido como toda aquele que envolve a caixa torácica, arcabouço osteomuscular que aloja o coração, os pulmões, as pleuras e as estruturas do mediastino. Pode ser superficial ou causar risco de vida imediato às vítimas. No Brasil, a maioria dos atendimentos é decorrente da violência urbana. Objetivo: avaliar o aspecto clínico-epidemiológico dos pacientes vítimas de trauma torácico atendidos no Hospital de Urgência de Sergipe, Aracaju/SE, Brasil. Métodos: estudo transversal, observacional e prospectivo, realizado durante onze meses, com 100 pacientes politraumatizados. Formulário semiestruturado foi aplicado, e os dados sistematizados, analisados e testados estatisticamente considerando-se a margem de erro de 5%. Resultados: 85% dos pacientes eram do gênero masculino, com idade média de 39,3 e faixa etária de 30 a 49 anos; 57% deles possuíam ensino fundamental incompleto, 70% tinham renda familiar de até 2 salários mínimos e 41% eram provenientes da Grande Aracaju. Quanto ao mecanismo de trauma, 33% foi automobilístico, tendo como principal mecanismo o trauma contuso, e a principal consequência a fratura de arcos costais. Dentre os ferimentos penetrantes, os FAB (26%) e FAF (21%) foram os mais prevalentes, sendo o hemotórax sua principal consequência, sendo maioria dos pacientes submetida a toracostomia (59%). Conclusão: o perfil encontrado foi de homens, jovens, vítimas da violência urbana. A toracostomia foi resolutiva na maioria dos casos e deve ser instituída prontamente quando necessário. Uma menor parte dos pacientes necessitou de toracotomia, principalmente na presença de instabilidade hemodinâmica.

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Fraturas de esterno em uma unidade de tratamento intensivo especializada em trauma

Cited by 5 publications

References 12 publications

Sternal Fracture Due to Blunt Trauma

Sternal Fracture Due to Blunt Trauma

Clinical-epidemiological evaluation of victims of thoracic trauma in a reference hospital in Aracaju-SE

Avaliação clínico-epidemiológica dos pacientes vítimas de trauma torácico em um hospital de referência de Aracaju-SE

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