PMID: 3770934Sep 1, 1986Paper

Problems caused by the unstable thoracic wall and by cardiac injury due to blunt injury

Injury
W Glinz

Abstract

The treatment of flail chest remains highly controversial. In the literature convincing arguments can be found to support any therapeutic procedure. Newer concepts of mechanical ventilation such as SIMV and CPAP, as well as the use of epidural analgesia, have resulted in a significant reduction in the duration of artificial ventilation. Although the mechanical problems are generally overestimated in this situation, the use of a ventilator is indicated in many cases because of the associated lung damage. Internal fixation of the unstable thoracic wall is restricted to special, selected cases which would otherwise require artificial ventilation, without severe lung injury and without head injury. We found stabilization of bilateral parasternal rib fractures with a retrosternal Sulamaa bar most helpful. Cardiac injuries were present in 16 per cent of our patients admitted after severe blunt thoracic injury. Most of these had myocardial contusion. The analysis of 108 cases of cardiac contusion revealed that every possible variation of ECG can be observed. Repolarization disturbances and impairment of the cardiac rhythm and the conduction system were found most frequently. A ratio of CPK-MB: total CPK of over 6 per cent provides a v...Continue Reading

References

Apr 1, 1975·The Annals of Thoracic Surgery·J K TrinkleF M Holmstrom
Apr 1, 1979·Chest·P ChristenssonN M Ohlsson
Apr 1, 1978·Intensive Care Medicine·R D Cane, N Buchanan
Oct 1, 1975·Thorax·F ParísR Montero
May 1, 1975·Annals of Surgery·J W JonesT Drapanas
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Mar 1, 1982·Intensive Care Medicine·M DittmannG Wolff
Jan 1, 1981·Intensive Care Medicine·R C MacdonaldI M Ledingham

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Citations

Aug 16, 2011·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·M BemelmanL P H Leenen
Jul 27, 2007·Thoracic Surgery Clinics·Brian L PettifordRodney J Landreneau
Nov 8, 2014·La Radiologia medica·Vittorio MieleMargherita Trinci
Dec 27, 2012·The Journal of Trauma and Acute Care Surgery·Bruce SimonUNKNOWN Eastern Association for the Surgery of Trauma
Jan 27, 2005·The American Journal of Emergency Medicine·Roland LadurnerThomas Mussack

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