Fixation of Multiple-Segmented Costosternal Cartilage Fracture in Flail Chest Injury: A Case Report
DOI:
https://doi.org/10.31584/jhsmr.2020735Keywords:
chest wall stabilization, costosternal fixation, flail chest, rib fixation, thoracic traumaAbstract
Early internal fixation of rib fractures in the setting of flail chest has proven benefits over traditional conservative treatment. This can decrease pneumonia, time on mechanical ventilation, length of stay in intensive care units, need for tracheostomy and increase in the pulmonary function test. However, there are few reports regarding on how to restore the costochondral junction, or costal cartilage in cases of anterior or anterolateral flail chest involving cartilage matrix of the ribs or costochondral joint. This case report describes a surgical technique to restore the costochondral junction with plate osteosynthesis and the results.
References
1. Mitchell JD. Blunt chest trauma: is there a place for rib stabilization? J Thorac Dis 2017;9(Suppl 3):S211-7.
2. Athanassiadi K, Theakos N, Kalantzi N, Gerazounis M. Prognostic factors in flail-chest patients. Eur J Cardiothorac Surg 2010;38:466-71.
3. Dehghan N, de Mestral C, McKee MD, Schemitsch EH, Nathens A. Flail chest injuries: a review of outcomes and treatment practices from the National Trauma Data Bank. J Trauma Acute Care Surg 2014;76:462-8.
4. Vana PG, Neubauer DC, Luchette FA. Contemporary management of flail chest. Am Surg 2014;80:527-35.
5. Tanaka H, Yukioka T, Yamaguti Y, Shimizu S, Goto H, Matsuda H, et al. Surgical stabilization of internal pneumatic stabilization? A prospective randomized study of management of severe flail chest patients. J Trauma 2002;52:727-32.
6. Granetzny A, Abd El-Aal M, Emam E, Shalaby A, Boseila A. Surgical versus conservative treatment of flail chest. Evaluation of the pulmonary status. Interact Cardiovasc Thorac Surg 2005; 4:583-7.
7. Marasco SF, Davies AR, Cooper J, Varma D, Bennett V, Nevill R, et al. Prospective randomized controlled trial of operative rib fixation in traumatic flail chest. J Am Coll Surg 2013; 216:924-32.
8. De Moya M, Nirula R, Biffl W. Rib fixation: who, what, when? Trauma Surg Acute Care Open 2017;2:1-4.
9. Doben AR, Eriksson EA, Denlinger CE, Leon SM, Couillard DJ, Fakhry SM, et al. Surgical rib fixation for flail chest deformity improves liberation from mechanical ventilation. J Crit Care 2014;29:139-43.
10. Majercik S, Wilson E, Gardner S, Granger S, VanBoerum DH, White TW. In-hospital outcomes and costs of surgical stabilization versus nonoperative management of severe rib fractures. J Trauma Acute Care Surg 2015;79:533-8.
11. Wada T, Yasunaga H, Inokuchi R, Matsui H, Matsubara T, Ueda Y, et al. Effectiveness of surgical rib fixation on prolonged mechanical ventilation in patients with traumatic rib fractures: a propensity score-matched analysis. J Crit Care 2015;30:1227-31.
12. Leinicke JA, Elmore L, Freeman BD, Colditz GA. Operative management of rib fractures in the setting of flail chest: a systematic review and meta-analysis. Ann Surg 2013;258: 914-21.
13. Slobogean GP, MacPherson CA, Sun T, Pelletier ME, Hameed SM. Surgical fixation vs nonoperative management of flail chest: a meta-analysis. J Am Coll Surg 2013;216:302-11.
14. Schuurmans J, Goslings JC, Schepers T. Operative management versus non-operative management of rib fractures in flail chest injuries: a systematic review. Eur J Trauma Emerg Surg 2017; 43:163-8.
15. Swart E, Laratta J, Slobogean G, Mehta S. Operative treatment of rib fractures in flail chest injuries: a meta-analysis and cost-effectiveness analysis. J Orthop Trauma 2017;31:64-70.
2. Athanassiadi K, Theakos N, Kalantzi N, Gerazounis M. Prognostic factors in flail-chest patients. Eur J Cardiothorac Surg 2010;38:466-71.
3. Dehghan N, de Mestral C, McKee MD, Schemitsch EH, Nathens A. Flail chest injuries: a review of outcomes and treatment practices from the National Trauma Data Bank. J Trauma Acute Care Surg 2014;76:462-8.
4. Vana PG, Neubauer DC, Luchette FA. Contemporary management of flail chest. Am Surg 2014;80:527-35.
5. Tanaka H, Yukioka T, Yamaguti Y, Shimizu S, Goto H, Matsuda H, et al. Surgical stabilization of internal pneumatic stabilization? A prospective randomized study of management of severe flail chest patients. J Trauma 2002;52:727-32.
6. Granetzny A, Abd El-Aal M, Emam E, Shalaby A, Boseila A. Surgical versus conservative treatment of flail chest. Evaluation of the pulmonary status. Interact Cardiovasc Thorac Surg 2005; 4:583-7.
7. Marasco SF, Davies AR, Cooper J, Varma D, Bennett V, Nevill R, et al. Prospective randomized controlled trial of operative rib fixation in traumatic flail chest. J Am Coll Surg 2013; 216:924-32.
8. De Moya M, Nirula R, Biffl W. Rib fixation: who, what, when? Trauma Surg Acute Care Open 2017;2:1-4.
9. Doben AR, Eriksson EA, Denlinger CE, Leon SM, Couillard DJ, Fakhry SM, et al. Surgical rib fixation for flail chest deformity improves liberation from mechanical ventilation. J Crit Care 2014;29:139-43.
10. Majercik S, Wilson E, Gardner S, Granger S, VanBoerum DH, White TW. In-hospital outcomes and costs of surgical stabilization versus nonoperative management of severe rib fractures. J Trauma Acute Care Surg 2015;79:533-8.
11. Wada T, Yasunaga H, Inokuchi R, Matsui H, Matsubara T, Ueda Y, et al. Effectiveness of surgical rib fixation on prolonged mechanical ventilation in patients with traumatic rib fractures: a propensity score-matched analysis. J Crit Care 2015;30:1227-31.
12. Leinicke JA, Elmore L, Freeman BD, Colditz GA. Operative management of rib fractures in the setting of flail chest: a systematic review and meta-analysis. Ann Surg 2013;258: 914-21.
13. Slobogean GP, MacPherson CA, Sun T, Pelletier ME, Hameed SM. Surgical fixation vs nonoperative management of flail chest: a meta-analysis. J Am Coll Surg 2013;216:302-11.
14. Schuurmans J, Goslings JC, Schepers T. Operative management versus non-operative management of rib fractures in flail chest injuries: a systematic review. Eur J Trauma Emerg Surg 2017; 43:163-8.
15. Swart E, Laratta J, Slobogean G, Mehta S. Operative treatment of rib fractures in flail chest injuries: a meta-analysis and cost-effectiveness analysis. J Orthop Trauma 2017;31:64-70.
Downloads
Published
2020-04-22
How to Cite
1.
Dissaneewate P, Suksintharanon M, Chewakidakarn C, Orapiriyakul W, Kritsaneephaiboon A. Fixation of Multiple-Segmented Costosternal Cartilage Fracture in Flail Chest Injury: A Case Report. J Health Sci Med Res [Internet]. 2020 Apr. 22 [cited 2024 Nov. 23];38(3):239-43. Available from: https://he01.tci-thaijo.org/index.php/jhsmr/article/view/244171
Issue
Section
Case Report
