Improved chest wall trauma taxonomy: an interdisciplinary CWIS and ASER collaboration

Nguyen, Jonathan; Archer-Arroyo, Krystal; Gross, Joel A.; Steenburg, Scott D.; Sliker, Clint W.; Meyer, Courtney H.; Nummela, Mari T.; Pieracci, Fredric M.; Kaye, Adam J.

doi:10.1007/s10140-023-02171-4

Cited by 1 publication

(3 citation statements)

References 10 publications

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“…The median Intensive Care Unit (ICU) length of stay was 11 days (range: 7-17) with a median ventilator days of 7 (range: [6][7][8][9][10][11][12][13][14]. The median number of hours ventilated after surgery was 44 hours (range: 12-234).…”

Section: Resultsmentioning

confidence: 99%

“…Additionally, multiple studies support that early stabilization of the chest wall can reduce these rates. 10,11 However, there is lacking data surrounding ASIC which is traditionally a more damaging subtype of flail chest and often is associated with a more critically ill patient. This study demonstrates the successful operative management of 6 cases of ASIC.…”

Section: Discussionmentioning

confidence: 99%

“…10 This was further expanded by a multidisciplinary group of clinicians from CWIS and the American Society of Emergency Radiology (ASER). 11 However, both groups refer to anterior flail chest as injuries involving fractures of bilateral ribs. In our study we observed varying fracture patterns causing ASIC, a type of anterior flail chest, including patients that only had unilateral rib fractures.…”

Section: Discussionmentioning

confidence: 99%

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Is Traumatic Anterior Stove-In Chest Truly so Rare? A Single Institution Experience

Meyer,

Aworanti,

Santos

et al. 2023

The American Surgeon™

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Introduction The anterior stove-in chest (ASIC) is a rare form of flail chest involving bilateral rib or sternal fractures resulting in an unstable chest wall that caves into the thoracic cavity. Given ASIC has only been described in a handful of case reports, this study sought to review our institution’s experience in the surgical management of ASIC injuries. Methods A retrospective review of patients with ASIC was conducted at our level I trauma center from 1//2021 to 3//2023. Information pertaining to patient demographics, fracture pattern, operative management, and outcomes was obtained and compared across patients in the case series. Results 6 patients met inclusion criteria, all males aged 37-78 years. 5 suffered motor vehicle collisions, and 1 was a pedestrian struck by an automobile. The median injury severity score was 28. All received ORIF within 5 days of admission, most commonly for ongoing respiratory distress. Patients 2 and 4 underwent bilateral ORIF of the ribs and sternum while patients 1, 5, and 6 underwent left-sided repair. Patient 3 required ORIF of left ribs and the sternum to stabilize their injuries. 5 of 6 patients were liberated from the ventilator and survived to discharge. Conclusions This study demonstrates successful operative management of 6 patients with ASIC and suggests that early operative intervention with ORIF for affected segments may improve respiratory mechanics, ability to wean from the ventilator, and overall survival. Further research is needed to generate standardized guidelines for the management of this uncommon and complex thoracic injury.

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