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Zhao-Jie Liu, Jian Jia, Yin-Guang Zhang, Wei Tian, Xin Jin, Yong-Cheng Hu
The purpose of this article is to evaluate the efficacy and feasibility of preoperative surgery with 3D printing-assisted internal fixation of complicated acetabular fractures. A retrospective case review was performed for the above surgical procedure. A 23-year-old man was confirmed by radiological examination to have fractures of multiple ribs, with hemopneumothorax and communicated fractures of the left acetabulum. According to the Letounel and Judet classification, T-shaped fracture involving posterior wall was diagnosed...
May 2017: Orthopaedic Surgery
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
Lori DeFreest, Marcel Tafen, Avinash Bhakta, Ashar Ata, Stephen Martone, Owen Glotzer, Kevin Krautsak, Carl Rosati, Steven C Stain, Daniel Bonville
BACKGROUND: Open reduction and internal fixation (ORIF) of fractured ribs for flail chest is safe and effective but who is most likely to benefit is unknown. Our purpose is to compare ORIF with nonoperative management (NOM) in polytrauma patients. METHODS: Albany Medical Center Hospital Trauma Registry was queried for adult patients with flail chest admitted over 7 years. RESULTS: Eighty-six patients with radiographic flail chest were identified who met inclusion criteria...
April 2016: American Journal of Surgery
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
Babak Sarani, Leah Schulte, Jose J Diaz
Rib fracture is exceedingly common and remains a leading cause of death in patients with chest injury. Probability of death increases by 19% with each broken rib, and the probability of death increases further with age. Treatment is centered on pain control and early mobilization to provide adequate pulmonary hygiene. Multimodality interventions, such as incentive spirometry, postural changes, and coughing, are pivotal in minimizing the risk of pneumonia and death. Recently, many studies have found mortality benefit to operation fixation (ORIF) of ribs in select patients...
December 2015: Injury
Brett Mulawka, Aaron R Jacobson, Lisa K Schroder, Peter A Cole
OBJECTIVES: The purpose of this study is to report on a series of patients who sustained triple and quadruple disruptions to the superior shoulder suspensory complex (SSSC), their associated injuries, and functional outcomes of open reduction and internal fixation. DESIGN: Prospective observational study. SETTING: Level 1 trauma center. PATIENTS/PARTICIPANTS: Patients who sustained more than 2 lesions to the SSSC that underwent surgery...
June 2015: Journal of Orthopaedic Trauma
John G Skedros, Chad S Mears, Tanner D Langston, Don H Van Boerum, Thomas W White
INTRODUCTION: Rib plating is becoming increasingly common as a method for stabilizing a flail chest resulting from multiple rib fractures. Recent guidelines recommend surgical stabilization of a flail chest based on consistent evidence of its efficacy and lack of major safety concerns. But complications of this procedure can occur and are wide ranging. PRESENTATION OF CASE: We report an interesting case of a 58-year-old male patient that worked as a long-distance truck driver and had a flail chest from multiple bilateral rib fractures that occurred when his vehicle was blown over in a wind storm...
2014: International Journal of Surgery Case Reports
Mark Nikolaj Wiese, Nadine Kawel-Boehm, Pablo Moreno de la Santa, Feras Al-Shahrabani, Melanie Toffel, Rachel Rosenthal, Juliane Schäfer, Michael Tamm, Jens Bremerich, Didier Lardinois
OBJECTIVES: This is the experience with the Stratos system in two surgical centres for the management of two types of rib fractures: flail chest and multiple dislocated rib fractures with significant chest wall deformity. METHODS: From January 2009 to May 2012, 94 consecutive patients were included. Selected indications were extended anterolateral flail chest (n = 68) and dislocated painful rib fractures (n = 26). The open reduction internal fixation (ORIF) system consists of flexible titanium rib clamps and connecting plates...
May 2015: European Journal of Cardio-thoracic Surgery
Michael Zegg, Christian Kammerlander, Stefan Schmid, Tobias Roth, Ursula Kammerlander-Knauer, Markus Gosch, Thomas J Luger
In this case report, we present 2 cases of flail chest in geriatric patients after severe blunt chest trauma, which were treated at the University Hospital Innsbruck (Level I Trauma Center and Tyrolean Geriatric Fracture Center) by a multidisciplinary team of physicians from anesthesia, intensive care, trauma surgery, and acute geriatrics. We want to point out the benefit of a multidisciplinary approach in geriatric patients with flail chest.
December 2012: Geriatric Orthopaedic Surgery & Rehabilitation
Akash Bhatnagar, John Mayberry, Ram Nirula
BACKGROUND: Recently, rib fracture fixation for flail chest has been used increasingly at both academic and nonacademic trauma centers. Although a few small non-US studies have demonstrated a clinical benefit, it is unclear whether this benefit outweighs the added expense and potential perioperative complications related to the procedure. We therefore sought to determine if open reduction and internal fixation of ribs for flail chest (ORIF-FC) represents a cost-effective means for managing these patients...
August 2012: Journal of the American College of Surgeons
Peter L Althausen, Steven Shannon, Chad Watts, Kenneth Thomas, Martin A Bain, Daniel Coll, Timothy J O'mara, Timothy J Bray
OBJECTIVES: To compare the results of surgical stabilization with locked plating to nonoperative care of flail chest injuries. DESIGN: Retrospective case-control study. SETTING: Level II trauma center. PATIENTS/PARTICIPANTS: From January 2005 to January 2010, 22 patients with flail chest treated with locked plate fixation were compared with a matched cohort of 28 nonoperatively managed patients at our institution. INTERVENTION: Open reduction internal fixation of rib fractures with 2...
November 2011: Journal of Orthopaedic Trauma
Lisa A Taitsman, Sean E Nork, Chad P Coles, David P Barei, Julie Agel
OBJECTIVES: To describe the associated injuries, demographic distribution, and management of patients sustaining open clavicle fractures. DESIGN: Retrospective case series. SETTING: A single level-1 trauma center. PATIENTS: Twenty patients with open clavicle fractures were identified from a prospectively collected orthopaedic trauma registry. INTERVENTION: All patients were managed with surgical irrigation and debridement with or without internal fixation...
July 2006: Journal of Orthopaedic Trauma
J E Kuhlman, E K Fishman, P K Leichner, D Magid, S E Order, S S Siegelman
Over the past 6 years, the authors evaluated 300 patients with hepatoma as part of phase 1 and 2 treatment protocol trials. Analysis of the available clinical data and radiographic studies revealed 22 patients (7.3%) with skeletal metastases demonstrated by radiography, computed tomography (CT), and/or nuclear scintigraphy. The plain film appearance of skeletal metastases from hepatoma was osteolytic in all cases. CT scanning best demonstrated the expansile, destructive nature of these metastases, which were often associated with large, bulky soft-tissue masses...
July 1986: Radiology
N Schwarz, K Höcker
Thirty-six patients with Allman group-2 fractures of the clavicle were treated by ORIF with 2.7-mm ASIF dynamic compression plates. The indications for surgery were an open fracture in one patient, ipsilateral fractures of the arm or the ribs in five patients, bilateral clavicular fractures in one patient, and an inability to reduce the fracture in all other patients. There were no instances of deep infection. One patient suffered a refracture after plate removal; three patients developed pseudarthrosis because plates that were too short were used...
August 1992: Journal of Trauma
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