Surgical treatment of costal cartilage fractures with titanium plate internal fixation

Li, Yang; Zhao, Yongliang; Yang, Yi; Wu, Weiming; Guo, Xiang; Zhao, Tong

doi:10.1186/s13019-022-01801-1

Cited by 4 publications

(9 citation statements)

References 13 publications

(12 reference statements)

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“…With multiple nonunions and dislocations resulting essentially in a flail segment, his symptoms were unsurprising. Similar cases have been described in which patients suffering from multiple thoracic injuries underwent operative fixation with improved outcomes after reconstruction of rib fractures, costosternal nonunions, and costal cartilage fractures 3,5,13-15,18 . Surgical reconstruction of flail chest pathology has also demonstrated improvements in postoperative pulmonary function 19 .…”

Section: Discussionsupporting

confidence: 54%

“…In cases of multiple rib fractures, sternal fractures, and flail chest, studies have confirmed that operative fixation can result in improved pain and faster return to function 1,2,4,5,17 . Approximately 7% of all rib fracture admissions are actually misdiagnosed as costal cartilage fractures 3,10 . Furthermore, costal cartilage fractures may involve the lower costal margin or costosternal junction.…”

Section: Discussionmentioning

confidence: 99%

“…The literature is growing in favor of surgical fixation as a viable treatment 2,3,5,12 . Li et al reported statistically significant differences in preoperative and postoperative pain scores in patients undergoing internal fixation of costal cartilage fracture 3 .…”

Section: Discussionmentioning

confidence: 99%

“…The costochondral junction is a synchondrosis joint, and injuries to this joint should be diagnosed as costochondral subluxations or dislocations 10 . Unfortunately, there is limited literature regarding outcomes of surgical fixation of the costochondral junction, although these injuries affect long-term patient well-being 3,4,[11][12][13][14][15][16][17] .…”

mentioning

confidence: 99%

“…hest wall injuries are common after blunt chest trauma, with most patients sustaining concomitant rib fractures [1][2][3][4][5][6] . Although rib fractures have historically been treated nonoperatively, recent literature describes rib nonunion, increased hospitalization, and chronic pain after nonoperative management [2][3][4][5][6][7][8][9] . Costal cartilage injuries, initially missed or misdiagnosed as rib fractures, should be recorded in their own anatomic category according to a consensus statement from the Chest Wall Injury Society 10 .…”

mentioning

confidence: 99%

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Open Reduction and Internal Fixation of a Chronic Precordial Flail Chest Segment

Brahme

Laroque

Flagstad

et al. 2023

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Case: We report on a 35-year-old man presenting with disabling pain secondary to multiple rib nonunions and a costochondral dislocation 5 months after sustaining a chest wall crush injury. He underwent surgical reconstruction of the chest and was followed for 2 years. Surgical exposure to the heart was necessary during open reduction of the flail segment, followed by costochondral joint fixation with plates and screws. Although he was a workers’ compensation patient, he returned to full gainful employment. Conclusion: Open reduction and internal fixation of a symptomatic, chronically displaced, precordial, flail segment can relieve pain and promote return to baseline function.

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Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Open Reduction and Internal Fixation of a Chronic Precordial Flail Chest Segment

Brahme

Laroque

Flagstad

et al. 2023

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Bilateral costal cartilage fractures sustained in the gym during repeated bench press exercises

Thanalingam

Krim

Kejriwal

2022

Trauma Case Reports

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Hardware failure for anterior chest wall and costal cartilage injuries: A single-center experience

Varre,

Schweibinz,

Holzemer

et al. 2023

J Trauma Acute Care Surg

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Background Often missed in blunt chest wall injury, costal cartilage injuries can cause chest wall instability, refractory pain, and deformity. Notably, there is only a small amount of evidence regarding hardware performance when applied to costal cartilage. In a prior multi-center study, hardware failure rate was found to be approximately 3% following surgical stabilization of rib fractures (SSRF) for all fracture locations. The aim of the current study was to evaluate hardware performance for costal cartilage injuries. Methods All patients undergoing SSRF performed at our institution from 2016 to 2022 were queried, including both acute and chronic injuries. Both radiographic and clinical follow-up were retrospectively reviewed to evaluate for hardware failure defined as plate fracture, malposition, or screw migration following cartilage fixation. Results After screening 359 patients, 43 were included for analysis. Mean age was 64 years old, and 67% of patients were male. Median number of fractures per patient was 7 with 60% of patients sustaining a flail chest injury pattern. Median total plates per operation was 6 and median costal cartilage plates was 3. In total, 144 plates were applied to the costal cartilage for the group. Mean follow-up was as follows: clinical 88 days, 2-view plain radiography 164 days, and chest computed tomography 184 days. Hardware failure was observed in 3 of 144 plates (2.1%), in three separate patients. Two cases were asymptomatic and did not require intervention. One patient required revisional operation in the acute setting. Conclusion In our institution, hardware failure for costal cartilage fractures was observed to be 2.1%. This aligns with prior reports of hardware failure during SSRF for all injury locations. Surgical stabilization of anterior and cartilaginous chest wall injury with appropriate plate contouring and fixation technique appears to provide adequate stabilization with a relatively low rate of hardware malfunction. Level of Evidence Level V, Therapeutic/Care Management

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Surgical treatment of costal cartilage fractures with titanium plate internal fixation

Cited by 4 publications

References 13 publications

Open Reduction and Internal Fixation of a Chronic Precordial Flail Chest Segment

Open Reduction and Internal Fixation of a Chronic Precordial Flail Chest Segment

Bilateral costal cartilage fractures sustained in the gym during repeated bench press exercises

Hardware failure for anterior chest wall and costal cartilage injuries: A single-center experience

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