An analysis of the management and complications of multiple (three or more) rib fractures

Teste de introdução transdiafragmática de drenos torácicos em cadáveres de cães

“…O método proposto baseia-se em manobras semelhantes, porém forçando a pinça hemostática e o dreno pela parede abdominal cranial, utilizando os mesmos drenos de silicone. A execução da técnica justifica-se em casos de fraturas múltiplas de costelas, nos quais CAMERON et al (1949) e SÝRMALÝ et al (2003 salientaram a necessidade de drenagem torácica por tubo, mesmo em pacientes com as referidas lesões, objetivando remover ar ou sangue, permitindo a reexpansão pulmonar.…”

Intermittent positive pressure ventilation in the treatment of severe crushing injuries of the chest.

“…Mechanical fixation by itself is probably an inadequate form of treatment of the complex disturbances of physiology that result from such injuries, as evidenced by the large variety of methods that are in use and continue to be devised (Dolley and Brewer, 1942;McKim, 1943 ;Jaslow, 1946;Blades, 1949;Cameron, O'Rourke, and Burt, 1949;Coleman and Coleman, 1950;Heroy and Eggleston, 1951 ;Proctor and London, 1955;Henry, 1957;Jacques and Munro, 1958;Sillar, 1961;Schrire, 1963;Hadfield and Watkin, 1965). Continually moving cancellous bone is difficult to fix effectively, yet only when fully effective does fixation eliminate a flail segment.…”

Article Commentary: Rib Fracture Fixation: Controversies and Technical Challenges

“…[53][54][55][56] Surgeons of the modern era became reluctant to tape the chest wall because of concerns about excessive respiratory restriction, the potential for increasing the magnitude of rib fracture displacement, and because of a perceived lack of efficacy in the reduction of pain and mortality. 57,58 Drewes reported the spirographic compromise caused by chest wall strapping and recommended its use cautiously and only in ambulatory patients. 59 More recently, two small randomized trials have indicated that commercially available rib belts may be effective in decreasing rib fracture pain, but also increase the risk of hemothorax.…”