Operative Chest Wall Fixation with Osteosynthesis Plates

Engel, Christine; Krieg, James C.; Madey, Steven M.; Long, William B.; Bottlang, Michael

doi:10.1097/01.ta.0000063612.25756.60

Cited by 89 publications

(78 citation statements)

References 32 publications

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“…Flail chest injury may be life‐threatening resulting from deformity of the chest wall and volume loss of the lung 8, 21, 22, 23. This severe injury of the chest wall may be demonstrated by inefficient breathing and respiratory suppression caused by chest pain and/or overdose of analgesics.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for prolonged mechanical ventilation in patients with severe multiple injuries and blunt chest trauma: a single center retrospective case–control study

Okabe¹

2018

Acute Medicine & Surgery

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AimBlunt chest trauma is common and is associated with morbidity and mortality in patients with multiple injuries, frequently requiring invasive mechanical ventilation. The aim of this study was to elucidate risk factors for prolonged mechanical ventilation (PMV).MethodsConsecutive adult patients with multiple severe injuries and blunt chest trauma who treated in Chiba Emergency Medical Center (Chiba, Japan) between January 2008 and December 2015 were enrolled in this retrospective chart‐review study. According to ventilatory time, the patients were divided into PMV (≥7 days) and shortened mechanical ventilation (SMV; <7 days) groups. Thoracic Trauma Severity Score (TTSS) was calculated. To identify risk factors for PMV, univariate and multivariate logistic analyses and receiver operating characteristic analysis were carried out.ResultsEighty‐four and 49 patients were assigned to PMV and SMV groups, respectively. Compared with the SMV group, the PMV group had a significantly larger number of fractured ribs (P < 0.01), higher rate of severe Glasgow Coma Scale (GCS ≤8) (P < 0.05) and flail chest (P < 0.001), higher TTSS (P < 0.001), or longer intensive care unit and hospital stay (both P < 0.001). Logistic analysis showed that severe GCS (odds ratio [OR] = 4.6, P < 0.01), flail chest (OR = 3.0, P < 0.05), and TTSS (OR = 1.2; P < 0.01) were independent significant risk factors. Receiver operating characteristic analyses showed that the area under the curves for TTSS, flail chest, and severe GCS were 0.74, 0.70, and 0.58, respectively. When the three factors were combined, the area under the curve increased to 0.8.ConclusionSevere GCS (≤8), flail chest, or TTSS may be independent risk factors. Combining the three risk factors could provide high predictive performance for PMV.

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Section: Discussionmentioning

confidence: 99%

Risk factors for prolonged mechanical ventilation in patients with severe multiple injuries and blunt chest trauma: a single center retrospective case–control study

Okabe¹

2018

Acute Medicine & Surgery

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“…It may also cause physical deformity of the chest wall and loss of thoracic volume [11]. These in turn lead to decreased lung volume, atelectasis, chest tightness, dyspnea, and chronic pain [12,20].…”

Section: Discussionmentioning

confidence: 99%

Traumatic flail chest injuries and the benefits of epidural analgesia

B¹,

Babsail²,

Elhusseini³

et al. 2017

Clin Res Trials

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Introduction: Many poly-trauma patients sustain chest wall injuries. Flail chest is considered one of the uncommon injuries that may happen in traumatized patients and may increase morbidity and mortality in polytrauma patients. Pulmonary contusion, mechanical ventilation, pneumonia, sepsis and poor pain control are expected to be common complications in patients sustaining chest wall injuries. We hypothesize that the use of epidural analgesia can lead to improved clinical outcomes in this group of patients.

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“…A review of the literature shows that rib fixation has been achieved using various methods: plates, intramedullary devices, vertical bridging, and wiring. 3) The features of each method are following. Plates: Most general osteosynthesis plates exceed by far the bending stiffness of ribs, screw loosening due to stiff plate against flexible rib, conversely the special plates like Judet-struts have a very low stiffness.…”

Section: Discussionmentioning

confidence: 99%

Successful Surgical Fixation Using Bio-Absorbable Plates for Frail Chest in a Severe Osteoporotic Octogenarian

Waseda

Matsumoto

Tatsuzawa

et al. 2019

ATCS

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We present a case of a severe osteoporotic octogenarian who sustained serious flail chest from a traffic accident. The 3rd–9th ribs of the right chest wall were fractured. Non- operative management was unsuccessful. We performed a surgical fixation using a bio- absorbable and bio-active mini-plating set. This plating set is unsintered hydroxyapatite (u-HA) particles/poly-L-lactide (PLLA) composite osteosynthesis device commonly used for cranial, oral, and maxillofacial surgeries. The use of the u-HA/PLLA device for chest wall reconstruction has previously been reported, but no long-term results have been included. This case showed several advantages of the procedure with 4-year follow-up over other reported methods, especially in an osteoporotic elderly patient.

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Operative Chest Wall Fixation with Osteosynthesis Plates

Cited by 89 publications

References 32 publications

Risk factors for prolonged mechanical ventilation in patients with severe multiple injuries and blunt chest trauma: a single center retrospective case–control study

Risk factors for prolonged mechanical ventilation in patients with severe multiple injuries and blunt chest trauma: a single center retrospective case–control study

Traumatic flail chest injuries and the benefits of epidural analgesia

Successful Surgical Fixation Using Bio-Absorbable Plates for Frail Chest in a Severe Osteoporotic Octogenarian

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