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https://www.readbyqxmd.com/read/28214457/operative-fixation-of-rib-fractures-indications-techniques-and-outcomes
#1
David Galos, Benjamin Taylor, Toni McLaurin
Rib fractures are extremely common injuries and vary in there severity from single nondisplaced fractures to multiple segmental fractures resulting in flail chest and respiratory compromise. Historically, rib fractures have been treated conservatively with pain control and respiratory therapy. However this method may not be the best treatment modality in all situations. Operative fixation of select rib fractures has been increasing in popularity especially in patients with flail chest and respiratory compromise...
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28187475/concomitant-sternal-fracture-in-flail-chest-an-analysis-of-21-741-polytrauma-patients-from-the-traumaregister-dgu%C3%A2
#2
Stefan Schulz-Drost, Sebastian Krinner, Andreas Langenbach, Pascal Oppel, Rolf Lefering, Dominic Taylor, Friedrich F Hennig, Andreas Mauerer
Background Isolated sternal fractures (SFs) rarely show complications, but their influence in a thorax trauma of the seriously injured still remains unclear. Methods A retrospective analysis of the TraumaRegister DGU(®) was performed involving the years 2009 to 2013 (Injury Severity Score [ISS] ≥ 16, primary admission to a trauma center). Cohort formation: Unilateral and bilateral flail chest (FC) injuries with and without a concomitant SF, respectively. Results In total, 21,741 patients (25% female) met the inclusion criteria, with 3,492 (16...
February 10, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28186860/traumatic-rib-injury-patterns-imaging-pitfalls-complications-and-treatment
#3
Brett S Talbot, Christopher P Gange, Apeksha Chaturvedi, Nina Klionsky, Susan K Hobbs, Abhishek Chaturvedi
The ribs are frequently affected by blunt or penetrating injury to the thorax. In the emergency department setting, it is vital for the interpreting radiologist to not only identify the presence of rib injuries but also alert the clinician about organ-specific injury, specific traumatic patterns, and acute rib trauma complications that require emergent attention. Rib injuries can be separated into specific morphologic fracture patterns that include stress, buckle, nondisplaced, displaced, segmental, and pathologic fractures...
February 10, 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28120436/flail-chest-following-failed-cardiopulmonary-resuscitation
#4
Melissa Thompson, Neil E I Langlois, Roger W Byard
Following the death of a woman with blunt force chest trauma, the question was asked how common was the finding at autopsy of a flail chest in decedents after failed cardiopulmonary resuscitation. It was suggested in court that this was an uncommon occurrence. To address this issue, autopsy cases in adults (>18 years) with rib fractures attributable to cardiopulmonary resuscitation were taken from the files of Forensic Science SA over a 7-year period from 2008 to 2014. Flail chest injuries were defined as those arising from fractures at two sites in at least three consecutive ribs...
January 25, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28100942/potential-benefits-of-rib-fracture-fixation-in-patients-with-flail-chest-and-multiple-non-flail-rib-fractures
#5
Meiguang Qiu, Zhanjun Shi, Jun Xiao, Xuming Zhang, Shishui Ling, Hao Ling
The purpose of this study is to evaluate the potential benefits of rib fracture fixation in patients with flail chest and multiple non-flail rib fractures versus conventional treatment modalities. A retrospective reviewed study compared 86 cases which received surgical treatment between June 2009 and May 2013 to 76 cases which received conservative treatment between January 2006 and May 2009. The patients were divided into the flail chest (n = 38) and multiple non-flail rib fracture groups (n = 124)...
December 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28066906/causes-and-mechanisms-of-death-in-fatal-water-buffalo-attacks
#6
Roger W Byard
Deaths due to buffalo attack have not been well described. A 72-year-old man was trampled by a water buffalo (Bubalus bubalis) while attempting to move the animal within an enclosed area at an abattoir. At autopsy, there were numerous injuries involving the chest, head, neck, and left upper arm. Blunt force injury had resulted in multiple rib fractures with a flail chest and fracture/dislocation of the mid-cervical vertebrae caused either by physical crushing by the animal against the walls of the enclosure or by stomping...
January 9, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28030502/operative-fixation-of-rib-fractures-after-blunt-trauma-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma
#7
George Kasotakis, Erik A Hasenboehler, Erik W Streib, Nimitt Patel, Mayur B Patel, Louis Alarcon, Patrick L Bosarge, Joseph Love, Elliott R Haut, John J Como
BACKGROUND: Rib fractures are identified in 10% of all injury victims and are associated with significant morbidity (33%) and mortality (12%). Significant progress has been made in the management of rib fractures over the last few decades, including operative reduction and internal fixation (rib ORIF); however, the subset of patients that would benefit most from this procedure remains ill-defined. The aim of this project was to develop evidence-based recommendations. METHODS: Population, intervention, comparison and outcome (PICO) questions were formulated for patients with and without flail chest...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28007867/chest-wall-stabilization-in-ventilator-dependent-traumatic-flail-chest-patients-who-benefits-%C3%A2
#8
Gregor J Kocher, Siamak Sharafi, Luis Filipe Azenha, Ralph A Schmid
OBJECTIVES: Traumatic flail chest is a potentially life threatening injury, often associated with prolonged invasive mechanical ventilation and intensive care unit stay. This study evaluates the usefulness and cost-effectiveness of surgical rib stabilization in patients with flail chest resulting in ventilator dependent respiratory insufficiency. METHODS: A retrospective study on a consecutive series of patients with flail chest with the need for mechanical ventilation was performed...
December 22, 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27984449/operative-treatment-of-rib-fractures-in-flail-chest-injuries-a-meta-analysis-and-cost-effectiveness-analysis
#9
Eric Swart, Joseph Laratta, Gerard Slobogean, Samir Mehta
OBJECTIVES: Flail chest is a common injury sustained by patients who experience high-energy blunt chest trauma and results in severe respiratory compromise because of altered mechanics of respiration. There has been increased interest in operative fixation of these injuries with the intention of restoring the mechanical integrity of the chest wall, and several studies have shown that ventilation requirements and pulmonary complications may be decreased with operative intervention. The purpose of this study was to evaluate fixation of rib fractures in flail chest injuries using cost-effectiveness analysis, supported by systematic review and meta-analysis...
February 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27939010/addition-of-video-assisted-thoracoscopic-surgery-to-the-treatment-of-flail-chest
#10
Judith P M Schots, Yvonne L J Vissers, Karel W E Hulsewé, Berend Meesters, Paul A Hustinx, Annette Pijnenburg, Jan Siebenga, Erik R de Loos
BACKGROUND: Video-assisted thoracoscopic surgery (VATS) is increasingly used in chest trauma for diagnostic and therapeutic purposes. In this report we describe our single-institutional experience with VATS in the surgical treatment of patients with flail chest after high-energy trauma. METHODS: From January 2013 to July 2014, 15 patients with flail chest after high-energy trauma were treated in our hospital. The Injury Severity Score (ISS) ranged from 16 to 44...
December 7, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27821827/-surgically-managed-flail-chest-caused-by-resuscitation
#11
Sonofu Taketani, Yoshifumi Makimoto, Masafumi Kunitake, Tomoyuki Anegawa
A 84-year-old man who had experienced cardiac arrest in the ambulance was brought to the emergency room. He had been followed at outpatient after surgery for colon cancer and known to be suffered from mild renal impairment. The cardio pulmonary arrest was likely to be caused by acute exacerbation of that. He was resuscitated and immediately recovered without severe hypoxic encephalopathy or deterioration of renal function. However, the flail chest by manual cardiac compression sustained. It urged him to be managed under the ventilator and he seemed difficult to leave from that within a couple of weeks...
November 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27733996/analysis-of-sternal-fixation-results-according-to-plate-type-in-sternal-fracture
#12
Chun Sung Byun, Il Hwan Park, Wan Jin Hwang, Yeiwon Lee, Hyun Min Cho
BACKGROUND: Sternal fractures are relatively rare, and caused mainly by blunt anterior chest wall trauma. In most cases, sternal fractures are treated conservatively. However, if the patient exhibits problematic symptoms such as intractable chest wall pain or bony crepitus due to sternal instability, surgical correction is indicated. But no consensus exists regarding the most appropriate surgical method. We analyzed the results of surgical fixation in cases of sternal fracture in order to identify which surgical method led to the best outcomes...
October 2016: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27651410/rare-case-of-bilateral-traumatic-internal-carotid-artery-dissection
#13
Joanne May Jenkins, Joel Norton, Timothy Hampton, Robert Weeks
A 55-year-old man was working in a trench when the wall collapsed in on him, pinning him to the wall. On arrival in the emergency department the patient began reporting of right-sided headache. Neurological examination revealed left-sided reduced sensation with weakness. Whole-body CT scan showed right-sided flail chest and bilateral haemothorax as well as loss of flow and thinning of the distal right internal carotid artery (ICA) and loss of grey white matter differentiation in keeping with traumatic ICA dissection with a right middle cerebral artery (MCA) infarct...
September 20, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27607891/-functional-outcome-after-chest-wall-stabilisation
#14
T Kyriss, U Lenz, G Friedel
This overview reviews the current literature to compare the functional results after surgical and conservative treatment of patients with flail chest and multiple rib fractures. Regarding functional aspects, patients in the early phase after a thoracic trauma are those that benefit most from the stabilisation of the chest wall by internal fixation of the ribs. Patients recover faster from restrictive respiratory disorders, have less pain and return to the workplace earlier after an operation compared with those that receive conservative treatment...
September 2016: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/27602896/a-novel-method-of-using-bioabsorbable-materials-for-the-surgical-repair-of-flail-chest
#15
Yosuke Morodomi, Tatsuro Okamoto, Tetsuzo Tagawa, Fumihiro Shoji, Masakazu Katsura, Takatoshi Fujishita, Tetsuhiro Fujiyoshi, Tomohiko Akahoshi, Mitsuhiro Yasuda, Yoshihiko Maehara
No abstract text is available yet for this article.
November 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27572897/operative-management-versus-non-operative-management-of-rib-fractures-in-flail-chest-injuries-a-systematic-review
#16
Jaap Schuurmans, J C Goslings, T Schepers
PURPOSE: Flail chest is a life-threatening complication of severe chest trauma with a mortality rate of up to 15 %. The standard non-operative management has high comorbidities with pneumonia and often leads to extended Intensive Care Unit (ICU) stay, due to insufficient respiratory function and complications. The aim of this literature study was to investigate how operative management improves patient care for adults with flail chest. METHODS: Randomized-controlled trials comparing operative management versus non-operative management of flail chest were included in this systematic review and meta-analysis...
August 29, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27482027/management-of-rib-fractures-in-traumatic-flail-chest-a-meta-analysis-of-randomised-controlled-trials
#17
REVIEW
T A Coughlin, J W G Ng, K E Rollins, D P Forward, B J Ollivere
AIMS: Flail chest from a blunt injury to the thorax is associated with significant morbidity and mortality. Its management globally is predominantly non-operative; however, there are an increasing number of centres which undertake surgical stabilisation. The aim of this meta-analysis was to compare the efficacy of this approach with that of non-operative management. PATIENTS AND METHODS: A systematic search of the literature was carried out to identify randomised controlled trials (RCTs) which compared the clinical outcome of patients with a traumatic flail chest treated by surgical stabilisation of any kind with that of non-operative management...
August 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27438051/no-benefit-to-surgical-fixation-of-flail-chest-injuries-compared-with-modern-comprehensive-management-results-of-a-retrospective-cohort-study
#18
Jaclyn Farquhar, Yahya Almahrabi, Gerard Slobogean, Bronwyn Slobogean, Naisan Garraway, Richard K Simons, S Morad Hameed
BACKGROUND: Chest wall trauma is a common cause of morbidity and mortality. Recent technological advances and scientific publications have created a renewed interest in surgical fixation of flail chest. However, definitive data supporting surgical fixation are lacking, and its virtues have not been evaluated against modern, comprehensive management protocols. METHODS: Consecutive patients undergoing rib fracture fixation with rib-specific locking plates at 2 regional trauma centres between July 2010 and August 2012 were matched to historical controls with similar injury patterns and severity who were managed nonoperatively with modern, multidisciplinary protocols...
September 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/27431822/ereply-in-patients-with-acute-flail-chest-does-surgical-rib-fixation-improve-outcomes-in-terms-of-morbidity-and-mortality
#19
Rizwan Q Attia, Katharina L Schulte, Donald C Whitaker
No abstract text is available yet for this article.
August 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27355282/clinical-outcomes-of-surgical-stabilization-of-flail-chest-injury
#20
Benjamin C Taylor, T Ty Fowler, Bruce G French, Neysa Dominguez
INTRODUCTION: Recent reported success in surgical stabilization of flail chest has been described in small series, but scant evidence exists for this procedure in the orthopaedic literature. METHODS: We reviewed 88 consecutive patients who underwent surgical stabilization of flail chest, along with 88 consecutive patients with flail chest who underwent traditional closed management before initiation of our algorithm change to surgical management. RESULTS: Surgical stabilization of flail chest injuries led to statistically significant decreases in hospital length of stay, ventilator-dependency time, pneumonia, tracheostomy, and mortality rate...
August 2016: Journal of the American Academy of Orthopaedic Surgeons
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