Rib fractures are a consequence of the forces of various arthritis that the chest wall and the thoracic cage itself undergo, and are most often due to closed injuries (eg, motor vehicle collision, falls from height, and Hits with strong objects ..), but penetrating injuries (eg, wounds with sharp tools, gunshot injuries ...) can also result in rib fractures. Non-operative treatment is based on pain control and pulmonary support, which mainly aim to avoid the need for intubation, which is associated with increased levels of pulmonary disorders until death.
For patients who continue to have acute pain or instability of the chest wall (eg, flail chest), each of which impedes pulmonary function despite maximal medical therapy, or those with non-consolidating rib fractures and causing pain in the persistence and impairment of pulmonary function, surgicaly stabilization of fractured ribs, also known as osteosynthesis, are now well-known procedures that improve the quality of treatment of the traumatized patient.
The thoracic wall injury association has been established to better study all aspects related to the consequences, diagnosis and treatment of thoracic wall injuries .
Indications for osteosynthesis, patient preparation, operative technique for stabilizing fractured ribs and the results are quite significant.
2. Michelitsch C, Acklin YP, Hässig G, et al. Operative Stabilization of Chest Wall Trauma: Single-Center Report of Initial Management and Long-Term Outcome. World J Surg 2018; 42: 3918-26. 10.1007/s00268-018-4721-8
3. Ziegler DW, Agarwal NN. The morbidity and mortality of rib fractures. J Trauma 1994; 37: 975-9. 10.1097/00005373-199412000-00018
4. Lafferty PM, Anavian J, Will RE, et al. Operative treatment of chest wall injuries: indications, technique, and outcomes. J Bone Joint Surg Am 2011; 93: 97-110. 10.2106/JBJS.I.00696
5. Fraser SF, Tan C, Kuppusamy MK, et al. The role of a video-assisted thoracic approach for rib fixation.Eur J Trauma Emerg Surg 2017. 43:185-90. 10.1007/s00068-016-0641-1
6. Solberg BD, Moon CN, Nissim AA, et al. Treatment of chest wall implosion injuries without thoracotomy: technique and clinical outcomes. J Trauma 2009; 67: 8-13; discussion 13. 10.1097/TA.0b013e3181a8b3be
7. Tarng YW, Liu YY, Huang FD, et al. The surgical stabilization of multiple rib fractures using titanium elastic nail in blunt chest trauma with acute respiratory failure. Surg Endosc 2016; 30: 388-95. 10.1007/s00464-015-4207-9
8. De Campos JRM, White TW. Chest wall stabilization in trauma patients: why, when, and how? J Thorac Dis 2018,10: S951-S962. 10.21037/jtd.2018.04.69
9. Davignon, et. Al. Patholophysiology and management of the flail chest, Minerva Anestesiol. 2004 Apr;70(4):193-9
10. Kasotakis, G. et. al. Operative fixation of rib fractures after blunt trauma. J Trauma Acute Care Surg. 2017 Mar;82(3):618-626.
11. Voggenreiter G, Neudeck F, Aufmkolk M, Obertacke U, Schmit-Neuerburg KP. Operative chest wall stabilization in flail chest—outcomes of patients with or without pulmonary contusion. J Am Coll Surg. 1998; 187: 130–138.
12. Teng J, Cheng Y, Ni D, et al. Outcomes of traumatic flail chest treated by operative fixation versus conservative approach. Journal of Shanghai Jiaotong University. 2009; 29: 1495–1498.
13. Brasel, K et. al. Western Trauma Association Critical Decisions in Trauma: Management of Rib Fractures. J Trauma Acute Care Surg. 2017;82: 200–203.
14. Majercik, S., Pieracci, F. Thorac Surg Clin. 2017 May;27(2):113-121.
15. Hasenboehler E, et. al. Treatment of traumatic flail chest with muscular sparing open reduction and internal fixation: description of a surgical technique. J Trauma. 2011 Aug;71(2):494-501.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.