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rib instability

Jakov Mihanović, Ivan Bačić, Nina Sulen
Subcutaneous emphysema may aggravate traumatic pneumothorax treatment, especially when mechanical ventilation is required. Expectative management usually suffices, but when respiratory function is impaired surgical treatment might be indicated. Historically relevant methods are blowhole incisions and placement of various drains, often with related wound complications. Since the first report of negative pressure wound therapy for the treatment of severe subcutaneous emphysema in 2009, only few publications on use of commercially available sets were published...
February 2018: Trauma Case Reports
Rui Peng, Xiangrui Meng, Guangming Zhao, Yingming Li, Jianming Zhu
We study the structural instability mechanism and effect of a multi-echelon support in very-deep roadways. We conduct a scale model test for analysing the structural failure mechanism and the effect of multi-echelon support of roadways under high horizontal stress. Mechanical bearing structures are classified according to their secondary stress distribution and the strength degradation of the surrounding rock after roadway excavation. A new method is proposed by partitioning the mechanical bearing structure of the surrounding rock into weak, key and main coupling bearing stratums...
2018: PloS One
Kirsten Neckelmann, Rikke Hagelberg
Several patients suffer from rib fractures after traumas, and in severe cases it can be life-threatening. Until recently, attempts to perform surgical fixation in patients with instability have been unsuccessful. Chronic non-union causes persistent pain, disability and loss of quality of life. Implementation of surgical stabilization of rib fractures with tailored plates seems to improve pain relief, especially in cases of non-union but also in patients with instability of the chest wall after severe traumas, where advanced pain treatment (epidural catheter) is insufficient or weaning off fails...
February 5, 2018: Ugeskrift for Laeger
Mazda K Turel, Mena G Kerolus, Vincent C Traynelis
Background: The use of cervical interfacet spacers (CISs) to augment stability and provide solid arthrodesis at the atlantoaxial joint has not been studied in detail. The aim of this work is to report the outcomes with the use of machined allograft CISs at C1-2. Methods: A retrospective review of 19 patients who underwent an atlantoaxial fusion with the use of CISs was performed. All patients had instability documented with flexion and extension lateral radiographs...
October 2017: Journal of Craniovertebral Junction and Spine
S Rabiou, Y Ouadnouni, M Lakranbi, A Traibi, F Antoini, M Smahi
INTRODUCTION: The rib fractures and instability of the chest wall are the main lesions of closed chest trauma. These lesions can be a source of chronic, often disabling with daily discomfort resulting limitation of some activities. The objective of this study was to assess the prevalence of this phenomenon in order to improve the quality of early care. METHODOLOGY: Through an observational retrospective cohort study on a number of 41 patients supported and monitored for traumatic rib fractures at the Military Hospital of Meknes during the period from October 2010 to March 2016...
October 13, 2017: Revue de Pneumologie Clinique
J S Fannon, A C Fowler, I R Moyles
We summarize the present form of the instability theory for drumlin formation, which describes the coupled subglacial flow of ice, water and sediment. This model has evolved over the last 20 years, and is now at the point where it can predict instabilities corresponding to ribbed moraine, drumlins and mega-scale glacial lineations, but efforts to provide numerical solutions of the model have been limited. The present summary adds some slight nuances to previously published versions of the theory, notably concerning the constitutive description of the subglacial water film and its flow...
August 2017: Proceedings. Mathematical, Physical, and Engineering Sciences
Marina Tommasini Carrara de Sambuy, Tanya Michelle Burgess, Adeline Cambon-Binder, Christophe L Mathoulin
Background  Tears of the dorsal radiocarpal capsule at the level of the scapholunate interosseous ligament (SLIL) have recently been described in association with predynamic scapholunate instability. Purpose  The aim of this anatomical study of the dorsal capsulo-scapholunate septum (DCSS) was to examine the connection of the dorsal capsule on the SLIL and dorsal intercarpal ligament (DICL). Methods  Fourteen fresh frozen wrists from seven adult cadavers were dissected through a dorsal approach. Any dorsal attachment of the DICL on the dorsal surface of the SLIL, that is, the DCSS, was identified and measured (height and width)...
August 2017: Journal of Wrist Surgery
Sebastian Krinner, Sina Grupp, Pascal Oppel, Andreas Langenbach, Friedrich F Hennig, Stefan Schulz-Drost
BACKGROUND: Flexion and compression forces to the trunk can cause severe instability of the vertebral column and the anterior chest wall, mostly associated with an unstable fracture of the sternum. In combination, the worst case would be a complete disruption of the trunk. Some authors consider the sternum-rib-complex to be the fourth vertebral column. This study discusses the possibilities to treat instable trunk injuries with sternal fractures concomitant to vertebral spine fractures through anterior sternal plating employing a locked plate osteosynthesis in a low profile design instead of the use of bulky implants...
April 2017: Journal of Thoracic Disease
Hiroki Oba, Jun Takahashi, Kyoko Takano, Yuji Inaba, Mitsuo Motobayashi, Gen Nishimura, Shugo Kuraishi, Masayuki Shimizu, Shota Ikegami, Toshimasa Futatsugi, Masashi Uehara, Tomoki Kosho, Hiroyuki Kato, Koki Uno
STUDY DESIGN: Case report. OBJECTIVE: We report here on an 18-month-old boy with brachytelephalangic chondrodysplasia punctata (BCDP), whose atlantoaxial instability was successfully managed with occipitocervical instrumented fusion (OCF) using screw and rod instrumentations. SUMMARY OF BACKGROUND DATA: Recently, there have been a number of reports on BCDP with early onset of cervical myelopathy. Surgical OCF is a vital intervention to salvage affected individuals from the life-threatening morbidity...
December 1, 2017: Spine
David B Seder, Christine Lord, David J Gagnon
The postresuscitation period after a cardiac arrest is characterized by a wide range of physiological derangements. Variations between patients include preexisting medical problems, the underlying cause of the cardiac arrest, presence or absence of hemodynamic and circulatory instability, severity of the ischemia-reperfusion injury, and resuscitation-related injuries such as pulmonary aspiration and rib or sternal fractures. Although protocols can be applied to many elements of postresuscitation care, the widely disparate clinical condition of cardiac arrest survivors requires an individualized approach that stratifies patients according to their clinical profile and targets specific treatments to patients most likely to benefit...
November 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
Khaled M Mohamed, Michael M Murphy, Heather E Lawson, Ted Klemetti
Design of rib support systems in U.S. coal mines is based primarily on local practices and experience. A better understanding of current rib support practices in U.S. coal mines is crucial for developing a sound engineering rib support design tool. The objective of this paper is to analyze the current practices of rib control in U.S. coal mines. Twenty underground coal mines were studied representing various coal basins, coal seams, geology, loading conditions, and rib control strategies. The key findings are: (1) any rib design guideline or tool should take into account external rib support as well as internal bolting; (2) rib bolts on their own cannot contain rib spall, especially in soft ribs subjected to significant load-external rib control devices such as mesh are required in such cases to contain rib sloughing; (3) the majority of the studied mines follow the overburden depth and entry height thresholds recommended by the Program Information Bulletin 11-29 issued by the Mine Safety and Health Administration; (4) potential rib instability occurred when certain geological features prevailed-these include draw slate and/or bone coal near the rib/roof line, claystone partings, and soft coal bench overlain by rock strata; (5) 47% of the studied rib spall was classified as blocky-this could indicate a high potential of rib hazards; and (6) rib injury rates of the studied mines for the last three years emphasize the need for more rib control management for mines operating at overburden depths between 152...
January 2016: International Journal of Mining Science and Technology
Christian Liebsch, Nicolas Graf, Hans-Joachim Wilke
PURPOSE: The influence of the anterior rib cage on the stability of the human thoracic spine is not completely known. One of the most common surgical interventions on the anterior rib cage is the longitudinal median sternotomy and its fixation by wire cerclage. Therefore, the purpose of this in vitro study was to examine, if wire cerclage can restore the stability of the human thoracic spine after longitudinal median sternotomy. METHODS: Six fresh frozen human thoracic spine specimens (C7-L1, 56 years in average, range 50-65), including the intact rib cage without intercostal muscles, were tested in a spinal loading simulator and monitored with an optical motion tracking system...
May 2017: European Spine Journal
John K Hillier, Ioannis A Kougioumtzoglou, Chris R Stokes, Michael J Smith, Chris D Clark, Matteo S Spagnolo
Sediments beneath modern ice sheets exert a key control on their flow, but are largely inaccessible except through geophysics or boreholes. In contrast, palaeo-ice sheet beds are accessible, and typically characterised by numerous bedforms. However, the interaction between bedforms and ice flow is poorly constrained and it is not clear how bedform sizes might reflect ice flow conditions. To better understand this link we present a first exploration of a variety of statistical models to explain the size distribution of some common subglacial bedforms (i...
2016: PloS One
Umesh Srikantha, Kiran S Khanapure, Aniruddha T Jagannatha, Krishna C Joshi, Ravi G Varma, Alangar S Hegde
OBJECTIVE Minimally invasive techniques are being increasingly used to treat disorders of the cervical spine. They have a potential to reduce the postoperative neck discomfort subsequent to extensive muscle dissection associated with conventional atlantoaxial fusion procedures. The aim of this paper was to elaborate on the technique and results of minimally invasive atlantoaxial fusion. MATERIALS Minimally invasive atlantoaxial fusion was done initially in 4 fresh-frozen cadavers and subsequently in 5 clinical cases...
December 2016: Journal of Neurosurgery. Spine
S Schulz-Drost, S Grupp, M Pachowsky, P Oppel, S Krinner, A Mauerer, F F Hennig, A Langenbach
PURPOSE: Stabilizing techniques of flail chest injuries usually need wide approaches to the chest wall. Three main regions need to be considered when stabilizing the rib cage: median-anterior with dissection of pectoral muscle; lateral-axillary with dissection of musculi (mm) serratus, externus abdominis; posterior inter spinoscapular with division of mm rhomboidei, trapezius and latissimus dorsi. Severe morbidity due to these invasive approaches needs to be considered. This study discusses possibilities for minimized approaches to the shown regions...
April 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Gerard P Slobogean, Hyunchul Kim, Joseph P Russell, David J Stockton, Adam H Hsieh, Robert V O'Toole
BACKGROUND: Multiple rib fractures cause significant pain and potential for chest wall instability. Despite an emerging trend of surgical management of flail chest injuries, there are no studies examining the effect of rib fracture fixation on respiratory function. OBJECTIVES: Using a novel full thorax human cadaveric breathing model, we sought to explore the effect of flail chest injury and subsequent rib fracture fixation on respiratory outcomes. PATIENTS AND METHODS: We used five fresh human cadavers to generate negative breathing models in the left thorax to mimic physiologic respiration...
December 2015: Archives of Trauma Research
Marco Castori, Francesca Servadei, Luigi Laino, Giulia Pascolini, Romano Fabbri, Anna Elisabetta Cifani, Giovanna Scassellati Sforzolini, Evelina Silvestri, Paola Grammatico
Autosomal aneuploidies associate with multiple minor skeletal defects, which, in fetuses, are best appreciated post-mortem after specific anatomic preparations. The present study was aimed to define patterns of skeletal anomalies in autosomal aneuploidies at standard radiology in second trimester fetuses by comparing findings in and among genotypes and gestational ages. Aneuploid fetuses were selected for availability of radiographs of various axial and non-axial structures, mainly homeotic transformations, vertebral clefts, vertebral segmentation and ossification defects, absent/hypoplastic nasal bone, premature talar calcifications, and selected appendicular anomalies...
March 2016: American Journal of Medical Genetics. Part A
Martin Kaláb, Jan Karkoška, Milan Kamínek, Eva Matějková, Zuzana Slaměníková, Aleš Klváček, Petr Šantavý
OBJECTIVES: Deep sternal wound infection poses a serious problem in cardiac surgery, with an up to 40% risk of mortality. Massive loss of sternum bone tissue and adjacent ribs results in major chest wall instability causing respiratory insufficiency and defects of soft tissue healing. Proposals for managing the situation have been published but the complexity of the issue precludes unequivocal resolution. Capitalizing on orthopaedic experience, we used allogeneic bone graft of sternum as a viable option...
March 2016: Interactive Cardiovascular and Thoracic Surgery
B Stoica, S Paun, I Tanase, I Negoi, A Runcanu, M Beuran
INTRODUCTION: Despite the high frequency of thoracic injuries secondary to traffic related accidents, the blunt cardiac valve rupture is extremely rare. METHOD: Case report and review of the literature using PubMed/MEDLINE and EMBASE databases. RESULT: A 38 year old female patient, victim of car accident was admitted. On primary survey the patient was conscious, cooperative and hemodynamic and respiratory stable. On secondary survey was found a bilateral open leg fracture and a seat belt sign...
September 2015: Chirurgia
F Vyhnánek, D Jirava, M Očadlík, D Škrabalová
PURPOSE OF THE STUDY: Multiple rib fractures with segmental chest wall instability are caused by high-energy chest trauma and are associated with significant morbidity and mortality. Flail chest injuries are mostly combined with lung injury (contusion, rupture, laceration) and subsequent pneumothorax or haemothorax. Early mechanical ventilation with internal pneumatic splinting is a conservative treatment for flail chest in patients with respiratory insufficiency. The surgical stabilisation of a flail chest is an effective method of treatment and is beneficial for selected patients...
2015: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
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