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World Journal of Emergency Surgery
Published in: World Journal of Emergency Surgery 1/2012

Open Access 01-12-2012 | Case report

Thoracic hyperextension injury with complete “bony disruption” of the thoracic cage: Case report of a potentially life-threatening injury

Authors: James Bailey, Todd VanderHeiden, Clay Cothren Burlew, Sarah Pinski-Sibbel, Janeen Jordan, Ernest E Moore, Philip F Stahel

Published in: World Journal of Emergency Surgery | Issue 1/2012

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Abstract

Background

Severe chest wall injuries are potentially life-threatening injuries which require a standardized multidisciplinary management strategy for prevention of posttraumatic complications and adverse outcome.

Case presentation

We report the successful management of a 55-year old man who sustained a complete “bony disruption” of the thoracic cage secondary to an “all-terrain vehicle” roll-over accident. The injury pattern consisted of a bilateral “flail chest” with serial segmental rib fractures, bilateral hemo-pneumothoraces and pulmonary contusions, bilateral midshaft clavicle fractures, a displaced transverse sternum fracture with significant diastasis, and an unstable T9 hyperextension injury. After initial life-saving procedures, the chest wall injuries were sequentially stabilized by surgical fixation of bilateral clavicle fractures, locked plating of the displaced sternal fracture, and a two-level anterior spine fixation of the T9 hyperextension injury. The patient had an excellent radiological and physiological outcome at 6 months post injury.

Conclusion

Severe chest wall trauma with a complete “bony disruption” of the thoracic cage represents a rare, but detrimental injury pattern. Multidisciplinary management with a staged timing for addressing each of the critical injuries, represents the ideal approach for an excellent long-term outcome.
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Metadata
Title
Thoracic hyperextension injury with complete “bony disruption” of the thoracic cage: Case report of a potentially life-threatening injury
Authors
James Bailey
Todd VanderHeiden
Clay Cothren Burlew
Sarah Pinski-Sibbel
Janeen Jordan
Ernest E Moore
Philip F Stahel
Publication date
01-12-2012
Publisher
BioMed Central
Published in
World Journal of Emergency Surgery / Issue 1/2012
Electronic ISSN: 1749-7922
DOI
https://doi.org/10.1186/1749-7922-7-14

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