Operative Management of Rib Fractures in the Setting of Flail Chest

Leinicke, Jennifer A.; Elmore, Leisha C.; Freeman, Bradley D.; Colditz, Graham A.

doi:10.1097/sla.0b013e3182895bb0

Cited by 219 publications

(172 citation statements)

References 45 publications

Supporting

Mentioning

150

Contrasting

Unclassified

Order By: Relevance

“…If there is a dislocation of the upper hemithorax with marked dislocation, an operative care should be considered, for example following the procedure shown in this manuscript. The overwhelming majority of the described collective showed very good postoperative results and a high quality of life (20,21).…”

Section: Discussionmentioning

confidence: 99%

Surgical Stabilization of Costoclavicular Injuries - A Combination of Flail Chest Injuries and a Clavicula Fracture

Langenbach¹,

Pinther²,

Krinner³

et al. 2017

chr

View full text Add to dashboard Cite

RezumatDate generale: Leziunile cu volet costal (FCI) sunt asociate cu o rată ridicată de morbiditate şi mortalitate. Având în vedere că asocierea unei fracturi de claviculă concomitente cu FCI agravează chiar rezultatul, întrebarea care se pune este cum pot fi aceste leziuni costoclaviculare (CCI) gestionate chirurgical. Metode: 11 pacienţi cu CCI au fost trataţi chirurgical prin osteosinteză a claviculei şi a coastelor subiacente prin placă blocată, prin abordări chirurgicale limitate, sub anestezie generală. Pacienţii au fost urmăriţi la 2, 6, 12, 26 şi 52 de săptămâni. Rezultate: Toţi pacienţii au prezentat o deformare severă a peretelui toracic din cauza fracturilor puternic deplasate ale coastelor şi claviculei. Ei sufereau de durere şi de restrângerea mişcărilor respiratorii. Peretele toracic a putut fi restabilit la forma normală în toate cazurile, cu vindecare lipsită de complicaţii a oaselor şi confort sporit al pacientului. Fracturile claviculei şi celei de-a doua coaste au fost gestionate printr-o abordare inovatoare clavipectorală, iar celelalte prin abordări standard ale peretelui anterolateral şi posterolateral. Doi pacienţi s-au plâns de amorţeală în zona intervenţiei laterale şi de durere periscapulară peristentă. Concluzii: Stabilizarea chirurgicală ar putea reprezenta terapia adecvată în CCI cu fracturi dislocate, deoarece acestea ar putea cauza deformări severe şi pierderea funcţiei peretelui toracic şi a umărului.

show abstract

Section: Discussionmentioning

confidence: 99%

Surgical Stabilization of Costoclavicular Injuries - A Combination of Flail Chest Injuries and a Clavicula Fracture

Langenbach¹,

Pinther²,

Krinner³

et al. 2017

chr

View full text Add to dashboard Cite

show abstract

“…They occur in more than 16 % out of all polytrauma patients with an ISS of more than 16. Moreover an additional sternal fracture (SF) in those injuries occurs in about 10 % in case out of monolateral FCI and 21 % in bilateral FCI (1).…”

Section: Introductionmentioning

confidence: 99%

“…If the sternum ceases, painful instabilities as well as malformations with deformation of the anterior chest wall can result, which are to be treated accordingly, and with appropriate indication by surgical fixation (15)(16)(17). If, on the other hand, the sternum is accompanied by rib fractures, complex instabilities of the thoracic wall may develop, especially with ribs on both sides.…”

Section: Introductionmentioning

confidence: 99%

The Operative Management of Flail Chest Injuries with Concomitant Sternal Fracture

Schulz-Drost¹,

Krinner²,

Langenbach³

et al. 2017

chr

View full text Add to dashboard Cite

RezumatDate generale: Leziunile de volet costal (FCI) sunt unele dintre cele mai grave leziuni toracice. Mai mult decât atât, o fractură de stern suplimentară (SF) chiar agravează rezultatele, cum ar fi durata ventilaţiei mecanice, prin urmare o fixare chirurgicală a fracturilor poate fi luată în considerare în anumite cazuri pentru a grăbi deconectarea ventilatorului. Această lucrare urmăreşte să sublinieze managementul diferitelor tipuri de SF în FCI. Metode: Toate cazurile tratate chirurgical (2012)(2013)(2014)(2015)(2016) Original ArticleCuvinte cheie: volet costal, fractură de stern, fractură sternală, fractură costală, osteosinteză cu placă blocată, Matrix Rib Abstract Background: Flail Chest Injuries (FCI) are one of the most severe thoracic injuries. Moreover, an additional sternal fracture (SF) even worsens the outcome, such as the duration of mechanical ventilation, therefore an surgical fixation of the fractures could be considered in certain cases to improve the weaning from the ventilator. This paper aims to emphasize on the management of different types of SF in FCI. Methods: All surgically treated cases (2012)(2013)(2014)(2015)(2016) that showed the combination of FCI and SF have been evaluated for their clinical details, the morphology of the fractures and the technical aspects of the surgical procedure in a retrospective investigation.Results: All of the SF (n=15) had been fixed by locked plate osteosynthesis through a median approach in a supine position. Three main regions of the sternum showed the need for different fixation strategies: the upper manubrium, central and lower corpus sterni. Concomitant rib fractures were addressed either through the same approach or through additional limited incisions. Conclusions: Combinations of SF and FCI are high risc injuries with high demand on surgical skills. They can be properly fixed with a locking plate osteosynthesis through a combination of limited incisions employing different types of plates depending on the type of SF.

show abstract

“…In 2013, two meta-analyses were published specifically looking at surgical management of flail chest [11,12]. They both found that the data pool was limited and based mainly on small retrospective studies.…”

Section: Flail Chestmentioning

confidence: 99%

The Use of Novel Adopters for Acute Rib Fixation in Critical Chest Trauma, Undertaken by Orthopaedic Surgeons: an Observational Cohort Study

Jermin

Perry

Kalra

et al. 2015

The Journal of Critical Care Medicine

View full text Add to dashboard Cite

Background: Surgical stabilisation of acute rib fractures has recently undergone rapid change in the UK with respect to what type of injury is surgically stabilised and who undertakes the operation. This paper presents a review of the literature on surgical fixation and presents our early clinical experience using a recently introduced stabilising system. Methods: Data was prospectively collected from the first 10 patients undergoing surgical stabilisation of acute rib fractures using the Synthes Matrix RIB plating system. The data included demographics, Injury Severity Score, length of stay in Intensive Care, length of time on a ventilator, analgesic requirements, pneumonia rates and mortality. Patients were followed up until they were discharged from hospital. Results: Patients had an average Injury Severity Score of 26 (16-57), the average number of ribs fractured was 8.2 (4-14), nine patients had flail chest and one had multiple fractures, mean time from injury to fixation was 2.8 days.In the reported cohort, there were no deaths, two pneumonias (one had pneumonia on presentation). The average length of stay on a ventilator was three days and the average length of stay in Intensive Care was ten days. Conclusion:The early results of this procedure are encouraging. We feel that the modern implants will provide superior results to the highly variable implants that have previously been used. Our results support the literature, showing that with this system, there is a decrease in mortality and morbidity and a decrease in the length of time on a ventilator and stay in Intensive Care.

show abstract

Operative Management of Rib Fractures in the Setting of Flail Chest

Cited by 219 publications

References 45 publications

Surgical Stabilization of Costoclavicular Injuries - A Combination of Flail Chest Injuries and a Clavicula Fracture

Surgical Stabilization of Costoclavicular Injuries - A Combination of Flail Chest Injuries and a Clavicula Fracture

The Operative Management of Flail Chest Injuries with Concomitant Sternal Fracture

The Use of Novel Adopters for Acute Rib Fixation in Critical Chest Trauma, Undertaken by Orthopaedic Surgeons: an Observational Cohort Study

Contact Info

Product

Resources

About