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https://www.readbyqxmd.com/read/28383845/-surgical-fixation-in-flail-chest-a-local-first-encouraging-experience
#1
M Tonglet, Q Desiron, H Marechal, F Pitance, S Degesves
We report the case of a young woman who suffered from a severe traffic accident with major thoracic trauma consisting of hemopneumothorax and flail chest. At day 5 of mechanical ventilation, a surgical reduction and fixation of the fractured ribs were performed; the patient was liberated from mechanical ventilation the next day and discharged from the intensive care unit two days later. The success of this local first case incites us to further a similar approach in such challenging trauma cases.
July 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28372525/acute-forces-required-for-fatal-compression-asphyxia-a-biomechanical-model-and-historical-comparisons
#2
Mark W Kroll, G Keith Still, Tom S Neuman, Michael A Graham, Lanny V Griffin
Background Fatalities from acute compression have been reported with soft-drink vending machine tipping, motor vehicle accidents, and trench cave-ins. A major mechanism of such deaths is flail chest but the amount of force required is unclear. Between the range of a safe static chest compression force of 1000 N (102 kg with earth gravity) and a lethal dynamic force of 10-20 kN (falling 450 kg vending machines), there are limited quantitative human data on the force required to cause flail chest, which is a major correlate of acute fatal compression asphyxia...
January 1, 2017: Medicine, Science, and the Law
https://www.readbyqxmd.com/read/28363365/chest-wall-trauma
#3
REVIEW
Sarah Majercik, Fredric M Pieracci
Chest wall trauma is common, and contributes significantly to morbidity and mortality of trauma patients. Early identification of major chest wall and concomitant intrathoracic injuries is critical. Generalized management of multiple rib fractures and flail chest consists of adequate pain control (including locoregional modalities); management of pulmonary dysfunction by invasive and noninvasive means; and, in some cases, surgical fixation. Multiple studies have shown that patients with flail chest have substantial benefit (decreased ventilator and intensive care unit days, improved pulmonary function, and improved long-term functional outcome) when they undergo surgery compared with nonoperative management...
May 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28241883/the-number-of-displaced-rib-fractures-is-more-predictive-for-complications-in-chest-trauma-patients
#4
Chih-Ying Chien, Yu-Hsien Chen, Shih-Tsung Han, Gerald N Blaney, Ting-Shuo Huang, Kuan-Fu Chen
BACKGROUND: Traumatic rib fractures can cause chest complications that need further treatment and hospitalization. We hypothesized that an increase in the number of displaced rib fractures will be accompanied by an increase in chest complications. METHODS: We retrospectively reviewed the trauma registry between January 2013 and May 2015 in a teaching hospital in northeastern Taiwan. Patients admitted with chest trauma and rib fractures without concomitant severe brain, splenic, pelvic or liver injuries were included...
February 28, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28214457/operative-fixation-of-rib-fractures-indications-techniques-and-outcomes
#5
REVIEW
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
#6
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
#7
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...
March 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
#8
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
#9
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
#10
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
#11
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 past 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...
March 2017: 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
#12
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...
April 1, 2017: 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
#13
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
#14
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...
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27821827/-surgically-managed-flail-chest-caused-by-resuscitation
#15
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
#16
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
#17
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
#18
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
#19
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
#20
REVIEW
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...
April 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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