PMID: 17058657Oct 25, 2006Paper

Surgical fixation of the ribs for flail chest injuries

Kyobu geka. The Japanese journal of thoracic surgery
Seiichi KakegawaY Morishita

Abstract

The record of 20 patients presenting with flail chest injury from 1998 to 2005 was reviewed to determine surgical indication and timing. There were 4 groups with each indication as followed: 1) 8 patients with surgical indication for injury regions other than fractured ribs, 2) 5 without improvement of flail chest after internal pneumatic stabilization for more than 10 days, 3) 4 performed surgical fixation positively for flail chest with respiratory failure, 4) 3 with strong deformation of the thorax without respiratory failure. Eight patients (40%) required artificial respiration for more than 6 days after surgical stabilization. The reasons of prolonged artificial respiration included unconsciousness in 4 patients, pneumonia in 2, and others in 2. In the group consisting of 8 patients taking more than 6 days to be extubated after surgical fixation, the injury severity score (ISS) was significantly higher (p = 0.006) than that of the other group. In patients with no improvement of flail chest after internal pneumatic stabilization for more than 10 days, surgical fixation reduces the period of internal pneumatic stabilization and the risk of pneumonia. For the elderly who can develop complications easily, early indication of s...Continue Reading

Related Concepts

Flail Chest
Fracture Fixation
Mechanical Ventilation
Respiratory Failure
Rib Fractures
Bone Structure of Rib

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