Top

European Journal of Trauma and Emergency Surgery

Published in:

01-10-2010 | Review Article

Rib stabilization: lessons learned

Authors: M. G. Gasparri, W. B. Tisol, G. B. Haasler

Published in: European Journal of Trauma and Emergency Surgery | Issue 5/2010

Abstract

Introduction

The management of rib fractures and flail chest has changed considerably over the past century, and recently there has been a renewed interest in operative rib stabilization for these injuries. Despite numerous reports suggesting improved outcomes with rib stabilization, there are not well-defined indications and the approach remains somewhat controversial.

Materials and methods

The authors reflect on their experience of performing rib stabilization in over 100 patients with rib fractures and flail chest.

Conclusion

The authors offer their opinions on this operation with respect to rationale, indications, timing, technique, and postoperative care.

Haasler GB. Open fixation of flail chest after blunt trauma. Ann Thorac Surg. 1990;49:993–5.CrossRefPubMed

Sinha K, Dayal A, Charan A. Towel clip traction: a simple and effective method for the treatment of flail chest. Indian J Chest Dis. 1973;15:307–11.PubMed

Diethelm AG, Battle W. Management of flail chest injury: a review of 75 cases. Am Surg. 1971;37:667–70.PubMed

Avery EE, Morch ET, Benson DW. Critically crushed chests: a new method of treatment with continuous mechanical hyperventilation to produce alkalotic apnea and internal pneumatic stabilization. J Thorac Cardiovasc Surg. 1956;32:291–6.

Relihan M, Litwin MS. Morbidity and mortality associated with flail chest injury: a review of 85 cases. J Trauma. 1973;13:663–71.CrossRefPubMed

Trinkle JK, Richardson JD, Franz JL, Grover FL, Arom KV, Holmstrom FM. Management of flail chest without mechanical ventilation. Ann Thorac Surg. 1975;19:355–63.CrossRefPubMed

EAST Practice Management Workgroup (2006) Practice management guidelines for the treatment of pulmonary contusion/flail chest: an evidence based review. http://www.east.org/tpg/pulmcontflailchest.pdf.

Albaugh G, Kann B, Puc MM, Vemulapalli P, Marra S, Ross S. Age-adjusted outcomes in traumatic flail chest injuries in the elderly. Am Surg. 2000;66:978–81.

Bulger EM, Arneson MA, Mock CN, Jurkovich GJ. Rib fractures in the elderly. J Trauma. 2000;48:1040–7.CrossRefPubMed

10.

Landercasper J, Cogbill TH, Lindesmith LA. Long-term disability after flail chest injury. J Trauma. 1984;5:410–4.CrossRef

11.

Beal SL, Oreskovich MR. Long-term disability associated with flail chest injury. Am J Surg. 1985;150:324–6.CrossRefPubMed

12.

Tanaka H, Yukioka T, Yamaguti Y, Shimizu S, Goto H, Matsuda H, Shimazaki S. Surgical stabilization of internal pneumatic stabilization? A prospective randomized study of management of severe flail chest patients. J Trauma. 2002;52:727–32.CrossRefPubMed

13.

Granetzny A, Abd El-Aal M, Emam E, Shalaby A, Boseila A. Surgical versus conservative treatment of flail chest. Interact Cardiovasc Thorac Surg. 2005;4:583–7.CrossRefPubMed

14.

Voggenreiter G, Neudeck F, Aufmkolk M, Obertacke U, Schmit-Neuerburg KP. Operative chest wall sabilization in flail chest–outcomes of patients with or without pulmonary contusion. J Am Coll Surg. 1998;187:130–8.CrossRefPubMed

15.

Ahmed Z, Mohyuddin Z. Management of flail chest injury: internal fixation versus endotracheal intubation and ventilation. J Thorac Cardiovasc Surg. 1995;110:1676–80.CrossRefPubMed

16.

Nirula R, Diaz JJ Jr, Trunkey DD, Mayberry JC. Rib fracture repair: indications, technical issues, and future directions. World J Surg. 2009;33:14–22.CrossRefPubMed

17.

Ziegler DW, Agarwal NN. The morbidity and mortality of rib fractures. J Trauma. 1994;37:975–9.CrossRefPubMed

Title: Rib stabilization: lessons learned
Authors: M. G. Gasparri
W. B. Tisol
G. B. Haasler
Publication date: 01-10-2010
Publisher: Urban and Vogel
Published in: European Journal of Trauma and Emergency Surgery / Issue 5/2010
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-010-0048-3

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Rib stabilization: lessons learned

Abstract

Introduction

Materials and methods

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction

Materials and methods

Conclusion

Please log in to get access to this content

Other articles of this Issue 5/2010

Biomechanical rationale and evaluation of an implant system for rib fracture fixation

Operative stabilization of flail chest injuries: review of literature and fixation options

Intestinal derotation in emergency surgery

The impact of trauma mechanism on outcome: a follow-up study on health-related quality of life after major trauma

Putrid infectious pubic osteitis: case report and review of the literature on the differential diagnosis and treatment of infectious pubic osteitis and inflammatory pubic osteitis

Surface proteins and osteoblast markers: characterization of human adipose tissue-derived osteogenic cells