Our experience with chest wall stabilization
Authors:
M. Reška; I. Čapov; A. Peštál; J. Konečný; Z. Chovanec; V. Prudius; M. Benej; M. Páral; L. Veverková
Authors‘ workplace:
I. chirurgická klinika LF Masarykovy univerzity a FN u svaté Anny v Brně
přednosta: prof. MUDr. I. Čapov, CSc.
Published in:
Rozhl. Chir., 2017, roč. 96, č. 11, s. 469-474.
Category:
Original articles
Overview
Introduction:
An unstable chest wall is defined as a fracture of at least three adjacent ribs broken at least in two planes. As a result of impaired mechanical strength of the chest wall, paradoxical movements occur, resulting in insufficient pulmonary ventilation with the development of respiratory insufficiency with typical consequences – hypoxia, hypercapnia and acidosis.
Methods:
In this paper we describe a group of 16 patients who underwent stabilization of the chest wall. The average age of the group was 56 years, the youngest patient was 23 and the oldest one 76 years old. There was an average of 6.1 broken ribs per patient, individually ranging from 4 to 8. In 11 cases, the stabilization was performed for a block fracture, in 5 cases for a serial fracture with a thoracic wall deformity.
Results:
The average length of hospital stay was 19 days, the time from admission to surgery was 4.46 days, and the average duration of mechanical ventilation was 2.63 days. In our group, we had only one deep wound infection that was healed using vacuum therapy. Concerning other complications, there was one case of bronchopneumonia and one patient developed delirium. No redrainage for fluido- or pneumothorax was necessary.
Conclusion:
The main focus of this paper is on the active surgical approach to treatment of serial and block fractures of ribs with deformation or manifest instability of the chest wall. Not all patients with block fracture required stabilization, whereas 5 patients with serial fracture of the ribs were indicated for surgical revision for chest wall deformity and other complications.
Key words:
flail chest − treatment − indications
Sources
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Labels
Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2017 Issue 11
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