Skip to main content
SpringerLink
Log in

„Single-port-VATS“-assistierte Osteosynthese von Rippenserienfrakturen

Single-port VATS-assisted internal fixation of serial rib fractures

  • Kasuisiken
  • Published:
Der Unfallchirurg Aims and scope Submit manuscript

Zusammenfassung

Der Beitrag beschreibt die operative Stabilisierung einer traumatischen Rippenserienfraktur mit ausgeprägter Thoraxdeformierung und respiratorischer Insuffizienz. Konservative Maßnahmen mit systemischer und regionaler Analgesie sowie mit nichtinvasiver Beatmung erbrachten keine Besserung. Daher erfolgte die „Single-port-VATS“-assistierte Osteosynthese der Rippenfrakturen (VATS: „single-port video assisted thoracoscopic surgery“). Die Thorakoskopie erleichterte die Reposition der imprimierten Rippen und die gleichzeitige Bilanzierung intrathorakaler Pathologien.

Abstract

This article describes the operative stabilization of a flail chest due to traumatic serial rib fractures with extensive chest wall deformation and respiratory insufficiency. Initial conservative treatment including systemic and regional pain management and non-invasive positive pressure ventilation did not improve the pain or ventilation. Therefore, a single-port video-assisted thoracoscopic surgery (VATS) assisted internal fixation of the ribs was performed. The thoracoscopy enabled easy repositioning of the ribs and additionally an estimation of intrathoracic injuries.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4

Literatur

  1. Caragounis EC, Fagevik Olsen M, Pazooki D et al (2016) Surgical treatment of multiple rib fractures and flail chest in trauma: a one-year follow-up study. World J Emerg Surg 11:27

    Article  PubMed  PubMed Central  Google Scholar 

  2. DeFreest L, Tafen M, Bhakta A et al (2016) Open reduction and internal fixation of rib fractures in polytrauma patients with flail chest. Am J Surg 211:761–767

    Article  PubMed  Google Scholar 

  3. Fabricant L, Ham B, Mullins R et al (2013) Prolonged pain and disability are common after rib fractures. Am J Surg 205:511–515 (discusssion 515–516)

    Article  PubMed  Google Scholar 

  4. Granetzny A, Abd El-Aal M, Emam E et al (2005) Surgical versus conservative treatment of flail chest. Evaluation of the pulmonary status. Interact Cardiovasc Thorac Surg 4:583–587

    Article  PubMed  Google Scholar 

  5. Lafferty PM, Anavian J, Will RE et al (2011) Operative treatment of chest wall injuries: indications, technique, and outcomes. J Bone Joint Surg Am 93:97–110

    Article  PubMed  Google Scholar 

  6. Langenbach A, Pinther M, Krinner S et al (2017) Surgical stabilization of costoclavicular injuries – a combination of flail chest injuries and a clavicula fracture. Chirurgia (Bucur) 112:595–606

    Article  Google Scholar 

  7. Marasco S, Saxena P (2015) Surgical rib fixation – technical aspects. Injury 46:929–932

    Article  PubMed  Google Scholar 

  8. Marasco SF, Davies AR, Cooper J et al (2013) Prospective randomized controlled trial of operative rib fixation in traumatic flail chest. J Am Coll Surg 216:924–932

    Article  PubMed  Google Scholar 

  9. Nirula R, Diaz JJ Jr., Trunkey DD et al (2009) Rib fracture repair: indications, technical issues, and future directions. World J Surg 33:14–22

    Article  PubMed  Google Scholar 

  10. Richter T, Ragaller M (2011) Ventilation in chest trauma. J Emerg Trauma Shock 4:251–259

    Article  PubMed  PubMed Central  Google Scholar 

  11. Schulz-Drost S, Grupp S, Pachowsky M et al (2017) Stabilization of flail chest injuries: minimized approach techniques to treat the core of instability. Eur J Trauma Emerg Surg 43:169–178

    Article  CAS  PubMed  Google Scholar 

  12. Schulz-Drost S, Oppel P, Grupp S et al (2016) Bony injuries of the thoracic cage in multiple trauma: incidence, concomitant injuries, course and outcome. Unfallchirurg 119:1023–1030

    Article  CAS  PubMed  Google Scholar 

  13. Tanaka H, Yukioka T, Yamaguti Y et al (2002) Surgical stabilization of internal pneumatic stabilization? A prospective randomized study of management of severe flail chest patients. J Trauma 52:727–732 (discussion 732)

    PubMed  Google Scholar 

  14. Van Laarhoven JJ, Hietbrink F, Ferree S et al (2016) Associated thoracic injury in patients with a clavicle fracture: a retrospective analysis of 1461 polytrauma patients. Eur J Trauma Emerg Surg. https://doi.org/10.1007/s00068-016-0673-6

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. BG Unfallklinik Murnau, Prof.-Küntscher-Str. 8, 82418, Murnau am Staffelsee, Deutschland

    M. T. Berninger, F. Kellermann, A. Woltmann, V. Bühren & M. Lang

Authors
  1. M. T. Berninger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. F. Kellermann
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Woltmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. V. Bühren
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. Lang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. T. Berninger.

Ethics declarations

Interessenkonflikt

M.T. Berninger, F. Kellermann, A. Woltmann, V. Bühren und M. Lang geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren. Alle Patienten, die über Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts zu identifizieren sind, haben hierzu ihre schriftliche Einwilligung gegeben.

Additional information

Redaktion

W. Mutschler, München

H. Polzer, München

B. Ockert, München

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Berninger, M.T., Kellermann, F., Woltmann, A. et al. „Single-port-VATS“-assistierte Osteosynthese von Rippenserienfrakturen. Unfallchirurg 121, 335–338 (2018). https://doi.org/10.1007/s00113-018-0471-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00113-018-0471-1

Schlüsselwörter

Keywords

Search

Navigation