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rib fracture management

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https://www.readbyqxmd.com/read/29352361/the-modified-ravitch-approach-for-the-management-of-severe-anterior-flail-chest-with-bilateral-sternochondral-dislocations-a-case-report
#1
Gabriel Estremera, Ellen Chieko Omi, Eduardo Smith-Singares
The management of flail chest continues to evolve as scientific evidence and surgical experience accumulates. Flail chest injuries that span the sternum present a rare and complicated injury pattern that can be challenging to manage both medically and surgically. Our patient is a 69-year-old involved in a high-speed motor vehicle crash with respiratory failure secondary to an anterior flail chest. Tomographic examination confirmed a sternal fracture with bilateral sternochondral dislocations and multiple rib fractures...
January 19, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29336816/traumatic-thoracic-rib-cage-hernias-operative-management-and-proposal-for-a-new-anatomic-based-grading-system
#2
John Kuckelman, Riyad Karmy-Jones, Elizabeth Windell, Seth Izenberg, Jean-Stephane David, William Long, Matthew J Martin
BACKGROUND: Traumatic Rib Cage Hernias (TRCH) requiring operative repair are rare and there is currently no literature to guiding surgical management. METHODS: Perioperative review of TRCH over 32 years. Five operative grades were developed based on extent of tissue/bone damage, size, and location. RESULTS: Twenty-four patients (20 blunt, 4 penetrating) underwent operative repair. Lung was the herniated organ in 88% with a median of 4 rib fractures and average size of 60...
January 5, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29310353/complex-pelvic-ring-injuries-associated-with-floating-knee-in-a-poly-trauma-patient-a-case-report
#3
Yuebin Zhou, Honggang Guo, Zhiwei Cai, Yuan Zhang
RATIONALE: Complex pelvic ring fracture associated with floating knee is comparatively rare which usually results from high-energy trauma including vehicle-related accidence, falls from height, and earthquake-related injury. To our knowledge, few literatures have documented such injuries in the individual patient. Management of both injuries present challenges for surgical management and postoperative care. The purpose of this study is to prove the feasibility and benefits of damage control orthopedics (DCO)...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29230336/metastatic-spinal-cord-compression-secondary-to-liver-cancer
#4
Daniel Gams Massi, Japhari Nyassinde, Ngor Side Diagne, Ramy Abdennaji, Kamadore Toure, Moustapha Ndiaye, Amadou Gallo Diop, Mouhamadou Mansour Ndiaye
Metastatic spinal cord compression (MSCC) is a medical emergency that requires rapid diagnosis and treatment to reduce pain, to preserve neurological functioning, and to prolong survival. The diagnosis of liver cancer is often neglected in the differential diagnosis of MSCC. Treatment is usually palliative and evolution is often fatal. This is a case report of a 28-year-old patient living in Mauritania hospitalized in November 2014 at the neurology department of Fann national teaching hospital in Dakar, for the management of a chronic dorsal spinal cord compression...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29180034/surgical-stabilization-of-rib-fractures-a-single-institution-experience
#5
Erica D Kane, Elan Jeremitsky, Katharine R Bittner, Susan Kartiko, Andrew R Doben
BACKGROUND: Utilization of surgical stabilization of rib fractures (SSRF) has increased. Despite compelling small studies, many centers still struggle with determining criteria for intervention. We investigate the benefit of SSRF in our patients compared to non-operative (NonOp) National Trauma Databank (NTDB) Controls, specifically in the older population. STUDY DESIGN: Retrospective comparison of trauma patients with ≥3 and >5 rib fractures who underwent SSRF at a tertiary care Level I trauma center to non-operatively managed (NonOp) National Trauma Databank (NTDB) controls from equivalent Level I centers between 2007-2014...
November 24, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29153813/surgical-stabilization-of-rib-fractures-in-a-6-year-old-child-after-blunt-trauma
#6
Zaid M Abdelsattar, Michael B Ishitani, Brian D Kim
When identified, rib fractures in children are associated with high-energy trauma, nonaccidental trauma, or both. Traditionally, the optimal management of rib fractures in children is supportive care. In this case report, we present a 6-year-old boy who underwent surgical rib fixation for multiple displaced and comminuted rib fractures after being stepped on by a horse.
December 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29138069/traumatic-fractures-of-the-cervical-spine-analysis-of-changes-in-incidence-etiology-concurrent-injuries-and-complications-among-488-262-patients-from-2005-2013
#7
Peter G Passias, Gregory W Poorman, Frank A Segreto, Cyrus M Jalai, Samantha R Horn, Cole A Bortz, Dennis Vasquez-Montes, Bassel G Diebo, Shaleen Vira, Olivia J Bono, Rafael De La Garza-Ramos, John Y Moon, Charles Wang, Brandon P Hirsch, Peter L Zhou, Michael Gerling, Heiko Koller, Virginie Lafage
OBJECTIVE: The etiologies and epidemiology of traumatic cervical spine fracture have not been described with sufficient power or recency. Our goal is to describe demographics, incidence, etiology, spinal cord injuries (SCIs), concurrent injuries, treatments, and complications of traumatic cervical spine fractures. METHODS: Retrospective review of the Nationwide Inpatient Sample. ICD-9 E-Codes identified trauma cases from 2005-2013. Patients with cervical fracture were isolated...
November 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29124026/risk-factors-for-pneumonia-in-ventilated-trauma-patients-with-multiple-rib-fractures
#8
Hyun Oh Park, Dong Hoon Kang, Seong Ho Moon, Jun Ho Yang, Sung Hwan Kim, Joung Hun Byun
Background: Ventilator-associated pneumonia (VAP) is a common disease that may contribute to morbidity and mortality among trauma patients in the intensive care unit (ICU). This study evaluated the associations between trauma factors and the development of VAP in ventilated patients with multiple rib fractures. Methods: We retrospectively and consecutively evaluated 101 patients with multiple rib fractures who were ventilated and managed at our hospital between January 2010 and December 2015, analyzing the associations between VAP and trauma factors in these patients...
October 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29079373/longest-delayed-hemothorax-reported-after-blunt-chest-injury
#9
Darren Yap, Miane Ng, Madhu Chaudhury, Nik Mbakada
INTRODUCTION: Blunt chest injury is a common presentation to the emergency department. However, a delayed hemothorax after blunt trauma is rare; current literature reports a delay of up to 30days. We present a case of 44-day delay in hemothorax which has not been previously reported in current literature. CASE REPORT: A 52-year-old Caucasian male first presented to the emergency department complaining of persistent right sided chest pain 2weeks after having slipped on a wet surface at home...
October 16, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29054228/novel-airway-and-ventilator-management-of-tracheobronchial-disruption-after-blunt-trauma
#10
Nitin Mehdiratta, Michael Archer, Melissa Stewart, Bradley Dennis, Eric Grogan
Tracheobronchial injuries can be difficult to diagnose and manage, especially in the presence of polytrauma. A 50-year-old woman presented as a Level I trauma activation after being struck by a motor vehicle. Initial evaluation demonstrated intracranial hemorrhage and multiple chest injuries, including multilevel bilateral rib fractures, pneumomediastinum, and concern for tracheobronchial injury. After initial stabilization, bronchoscopy was performed and demonstrated an injury to the carina. We report a novel airway and ventilation strategy in the setting of concomitant tracheobronchial injury after severe blunt chest trauma in which extracorporeal support is contraindicated...
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29053055/successful-surgical-repair-and-recovery-in-a-2-week-old-infant-after-birth-related-cervical-fracture-dislocation
#11
Sara Saleh, Kyle I Swanson, Taryn Bragg
Cervical spine injuries are the most common spine injuries in the pediatric population. The authors present the youngest known patient who underwent cervical spine fusion to repair birth trauma-induced cervical fracture dislocation, resulting in spondyloptosis and spinal cord injury. A 2-week-old boy was found to have spondyloptosis and spinal cord injury after concerns arose from reduced movement of the extremities. The patient's birth was complicated by undiagnosed abdominal dystocia, which led to cervical distraction injury...
October 20, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29037487/-chronic-chest-pain-after-rib-fracture-it-can-cause-a-disability
#12
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
https://www.readbyqxmd.com/read/28965301/minimal-trauma-ankle-fractures-predominate-during-pregnancy-a-17-year-retrospective-study
#13
Madhuni Herath, Phillip Wong, Anne Trinh, Carolyn A Allan, Euan M Wallace, Peter R Ebeling, Peter J Fuller, Frances Milat
This study assessed all fractures occurring in pregnancy at a tertiary referral centre over a 17-year period. Most fractures were due to minimal trauma, and those involving the ankle were the most common. Women tended to fracture during their second and third trimesters and most required surgical intervention during pregnancy. PURPOSE: To characterise fractures in pregnancy over a 17-year period at a tertiary referral health service. METHODS: Medical records at the Monash Health in Australia were examined from 2000-2016 for fractures in pregnancy using the birthing outcome system database and the tenth revision of the International Statistical Classification of Diseases and Related Health Problems coding...
September 30, 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28958357/thoracic-trauma
#14
REVIEW
Bradley M Dennis, Seth A Bellister, Oscar D Guillamondegui
Management of chest trauma is integral to patient outcomes owing to the vital structures held within the thoracic cavity. Understanding traumatic chest injuries and appropriate management plays a pivotal role in the overall well-being of both blunt and penetrating trauma patients. Whether the injury includes rib fractures, associated pulmonary injuries, or tracheobronchial tree injuries, every facet of management may impact the short- and long-term outcomes, including mortality. This article elucidates the workup and management of the thoracic cage, pulmonary and tracheobronchial injuries...
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28958283/guideline-driven-care-improves-outcomes-in-patients-with-traumatic-rib-fractures
#15
Kathleen Flarity, Whitney C Rhodes, Andrew J Berson, Brian E Leininger, Paul E Reckard, Keyan D Riley, Charles P Shahan, Thomas J Schroeppel
There is no established national standard for rib fracture management. A clinical practice guideline (CPG) for rib fractures, including monitoring of pulmonary function, early initiation of aggressive loco-regional analgesia, and early identification of deteriorating respiratory function, was implemented in 2013. The objective of the study was to evaluate the effect of the CPG on hospital length of stay. Hospital length of stay (LOS) was compared for adult patients admitted to the hospital with rib fracture(s) two years before and two years after CPG implementation...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28947526/management-of-amiodarone-extravasation-with-intradermal-hyaluronidase
#16
Ashley N Fox, Ruben Villanueva, Jamie L Miller
PURPOSE: The case of a patient who experienced extravasation while receiving amiodarone via a peripheral infusion and was treated with intradermal hyaluronidase is reported. SUMMARY: A 60-year-old Caucasian man arrived at the emergency department after a motor vehicle collision. The patient was noted to have a subdural hematoma, multiple rib fractures, sternal body fracture, abdominal wall injury, left clavicle fracture, right humerus fracture, and vertebral fractures...
October 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28919152/erector-spinae-plane-esp-block-in-the-management-of-post-thoracotomy-pain-syndrome-a-case-series
#17
Mauricio Forero, Manikandan Rajarathinam, Sanjib Adhikary, Ki Jinn Chin
BACKGROUND AND AIMS: Post thoracotomy pain syndrome (PTPS) remains a common complication of thoracic surgery with significant impact on patients' quality of life. Management usually involves a multidisciplinary approach that includes oral and topical analgesics, performing appropriate interventional techniques, and coordinating additional care such as physiotherapy, psychotherapy and rehabilitation. A variety of interventional procedures have been described to treat PTPS that is inadequately managed with systemic or topical analgesics...
October 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28902086/operative-stabilization-of-flail-chest-injuries-reduces-mortality-to-that-of-stable-chest-wall-injuries
#18
Niloofar Dehghan, Jeffrey M Mah, Emil H Schemitsch, Aaron Nauth, Milena Vicente, Michael D McKee
OBJECTIVE: To determine the prevalence, management and outcomes of patients with flail chest injuries, compared to patients without flail chest injuries (single rib fractures and multiple rib fractures without a flail segment). DESIGN: Retrospective cohort study SETTING:: Ontario, Canada PARTICIPANTS:: Ontario residents over the age of 16 who had been admitted to hospital with a chest wall injury from 2004 to 2015 were identified using administrative health care databases...
August 29, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28870847/bundle-of-care-for-blunt-chest-trauma-patients-improves-analgesia-but-increases-rates-of-intensive-care-unit-admission-a-retrospective-case-control-study
#19
Cédric Carrie, Laurent Stecken, Elsa Cayrol, Vincent Cottenceau, Laurent Petit, Philippe Revel, Matthieu Biais, François Sztark
INTRODUCTION: This single-centre retrospective case-control study aimed to assess the effectiveness of a multidisciplinary clinical pathway for blunt chest trauma patients admitted in emergency department (ED). PATIENTS AND METHODS: All consecutive blunt chest trauma patients with more than 3 rib fractures and no indication of mechanical ventilation were compared to a retrospective cohort over two 24-month periods, before and after the introduction of the bundle of care...
September 21, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28852454/minimally-invasive-management-of-traumatic-lung-herniation
#20
Pablo Pérez Castro, Felipe Undurraga Machicao, Raimundo Santolaya Cohen, Raul Berrios Silva, Francisco Rivera
Post-traumatic pulmonary hernia can occur immediately after thoracic trauma or it may also appear months or even years after the onset. We report a case of a seventeen year-old male patient with thoracic blunt trauma secondary to high energy bicycle accident. Chest CT shows moderate hemothorax and pneumothorax, displaced fracture of the fifth left rib, and protusion of pulmonary tissue through a chest wall defect. In the Emergency Room the patient presents with chest pain (7/10 in Visual Analog Scale) and respiratory distress...
July 2017: Journal of Surgical Case Reports
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