No abstract available.
Flail Chest*

No abstract available.
Flail Chest*

No abstract available.
Flail Chest*

Background: Flail chest is a severe condition of thoracic trauma, and it requires diagnosis and treatment as soon as possible. From year 2000, we developed an improved technique of open fixation in order to adapt the situations of Vietnam health settings. Objectives: To report preliminary results of application of improved open fixation technique in Viet Duc Hospital from 2001 to 2006. Subjects and method: This descriptive, prospective and retrospective study involved 19 patients with flail chest due to closed thoracic trauma or multiple traumas, treated by open fixation technique. The parameters included features of patients, characteristics of this technique and postoperative progression.Results: Of 19 patients, there were 16 males and 3 females, mean age: 47.8 years. All patients presented obvious signs of flail chest preoperatively, but only 9 cases were treated by open fixation technique and pleural drainage immediately. This technique canbe applied in all sugical settings with single local anaesthesia, and any kind of common surgical threads. The most suitable initial pulled weight is 2000 g. All cases of flail chest required pleural drainage. All patients had good outcomes with open fixation technique, no death. There were 3 patients with postoperative complications, all were severe multiple trauma patients. Conclusion: Improved open fixation technique applied in Viet Duc Hospital is simple, effective and safe, and can be widely used in all surgical settings.
Flail Chest ; Flank Pain/ therapy ;

No abstract available.
Flail Chest ; Intestinal Diseases ; Strikes, Employee

More than a century ago, the first scientific report was published about fracture fixation with plates. During the 1950's, open reduction and plate fixation for fractures were standardized by the founders of Arbeitsgemeinschaft fur osteosynthesefragen/Association for the Study of Internal Fixation. Since the introduction of plate fixation for fractures, several plates and screws have been developed, all with their own characteristics. To accomplice more fracture stability, it was thought the bigger the plate, the better. The counter side was a compromised blood supply of the bone, often resulting in bone necrosis and ultimately delayed or non-union. With the search and development of new materials and techniques for fracture fixation, less invasive procedures have become increasingly popular. This resulted in the minimally invasive plate osteosynthesis (MIPO) technique for fracture fixation. With the MIPO technique, procedures could be performed with smaller incisions and thus with less soft tissue damage and a better preserved blood supply. The last 5 years rib fixation has become increasingly popular, rising evidence has become available suggesting that surgical rib fixation improves outcome of patients with a flail chest or isolated rib fractures. Many surgical approaches for rib fixation have been described in the old literature, however, most of these techniques are obscure nowadays. Currently mostly large incisions with considerable surgical insult are used to stabilize rib fractures. We think that MIPO deserves a place in the surgical treatment of rib fractures. We present the aspects of diagnosis, preoperative planning and operative techniques in regard to MIPO rib fixation.
Diagnosis ; Flail Chest ; Fracture Fixation ; Humans ; Necrosis ; Rib Fractures ; Ribs* ; Surgical Procedures, Minimally Invasive

Judet's rib struts which are designed for osteosynthesis are made of stainless steel. This report describes clinical analysis of our experiences of 30 cases with the operative stabilization of multiple rib fractures with Judet's rib struts from December, 1995, to December, 1996 in Chungmoo Hospital, Chounan. Our indications for operative stabilization were as follows: 14 cases in flail chest, 8 cases in severe displacement of rib including segmental fractures, 7 cases in additional procedures during intrathoracic operation, and 1 case in other cause. Postoperative artificial ventilation is needed in only 1 case for 5 days and posto- perative complications were few: 2 cases of hemopneumothorax, 2 cases of alcohol with- drawal delirium, and 1 case of postoperative hepatitis. Average duration of hospital admission who have limited thoracic injuries was 10.5 days. Though more comparative studies is necessary, we find this technique to be better than previously published methods, since it provides better stabilization and immobilization of the ribs and shortening the duration of hospital admission.
Delirium ; Flail Chest ; Hemopneumothorax ; Hepatitis ; Immobilization ; Rib Fractures* ; Ribs* ; Stainless Steel ; Thoracic Injuries ; Ventilation

Rib fractures are a common injury resulting from blunt chest trauma. The most important complications associated with rib fractures include death, pneumonia, and the need for mechanical ventilation. The development of new osteosynthesis materials has stimulated increased interest in the surgical treatment of rib fractures. Surgical stabilisation, however, is not needed for every patient with rib fractures or for every patient with flail chest. This paper presents an easy-to-use evidence-based algorithm, developed by the authors, for the treatment of patients with flail chest and isolated rib fractures.
Flail Chest ; Humans ; Mortality ; Pneumonia ; Respiration, Artificial ; Rib Fractures* ; Ribs* ; Thorax

Surgical stabilization of the flail chest is challenging and has no established guidelines. Chest wall integrity and stability are the main factors that ensure the protection of intrathoracic organs and an adequate respiratory function. Here, we report a novel chest wall reconstruction technique in a 45-year-old man with a traumatic left flail chest and open pneumothorax diagnosed both clinically and radiographically. Rib approximation and chest wall reconstruction was done using intercostal figure-of-eight suture and polypropylene mesh with vascularized musculofascial flap. The patient improved gradually and was discharged after three weeks of total hospital stay. He returned to regular working after a month with no evidence of respiratory distress or paradoxical chest movement. Follow-up visit at one year revealed no lung hernia or paradoxical chest movement. This is a novel, feasible and cost-effective modification of chest wall reconstruction that can be adopted for thoracic wall repair in case of open flail chest, which needs emergency surgical interventions even in resource constraint settings.
Flail Chest/surgery* ; Humans ; Male ; Middle Aged ; Polypropylenes ; Surgical Mesh ; Sutures ; Thoracic Wall/surgery*

Rib fracture is the most common injury in chest trauma. Most of patients with rib fractures were treated conservatively, but up to 50% of patients, especially those with combined injury such as flail chest, presented chronic pain or chest wall deformities, and more than 30% had long-term disabilities, unable to retain a full-time job. In the past two decades, surgery for rib fractures has achieving good outcomes. However, in clinic, there are still some problems including inconsistency in surgical indications and quality control in medical services. Before the year of 2018, there were 3 guidelines on the management of regional traumatic rib fractures were published at home and abroad, focusing on the guidance of the overall treatment decisions and plans; another clinical guideline about the surgical treatment of rib fractures lacks recent related progress in surgical treatment of rib fractures. The Chinese Society of Traumatology, Chinese Medical Association, and the Chinese College of Trauma Surgeons, Chinese Medical Doctor Association organized experts from cardiothoracic surgery, trauma surgery, acute care surgery, orthopedics and other disciplines to participate together, following the principle of evidence-based medicine and in line with the scientific nature and practicality, formulated the Chinese consensus for surgical treatment of traumatic rib fractures (STTRF 2021). This expert consensus put forward some clear, applicable, and graded recommendations from seven aspects: preoperative imaging evaluation, surgical indications, timing of surgery, surgical methods, rib fracture sites for surgical fixation, internal fixation method and material selection, treatment of combined injuries in rib fractures, in order to provide guidance and reference for surgical treatment of traumatic rib fractures.
China ; Consensus ; Flail Chest ; Fracture Fixation, Internal ; Humans ; Rib Fractures/surgery* ; Thoracic Injuries