936 results match your criteria Flail Chest


The benefits of early rib fixation for clinical outcomes of flail chest patients in intensive care unit.

Turk Gogus Kalp Damar Cerrahisi Derg 2019 Jun 22;28(2):331-339. Epub 2020 Apr 22.

Department of Thoracic Surgery, Izmir Katip Çelebi University, Izmir, Turkey.

Background: In the present study, we aimed to compare clinical results of conservative and surgical stabilization approaches and to investigate the effect of early reduction in patients with a flail chest.

Methods: Between March 2013 and December 2017, 34 patients (23 males, 11 females; mean age 43.7±12. Read More

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http://dx.doi.org/10.5606/tgkdc.dergisi.2020.18439DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298373PMC

Traumatic rib fractures: a marker of severe injury. A nationwide study using the National Trauma Data Bank.

Trauma Surg Acute Care Open 2020 10;5(1):e000441. Epub 2020 Jun 10.

Department of Orthopaedic Surgery, Harvard Medical School Orthopedic Trauma Initiative, Massachusetts General Hospital, Boston, Massachusetts, USA.

Background: In recent years, there has been increasing interest in the treatment of patients with rib fractures. However, the current literature on the epidemiology and outcomes of rib fractures is outdated and inconsistent. Furthermore, although it has been suggested that there is a large heterogeneity among patients with traumatic rib fractures, there is insufficient literature reporting on the outcomes of different subgroups. Read More

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http://dx.doi.org/10.1136/tsaco-2020-000441DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292040PMC

Epidemiology and outcome of rib fractures: a nationwide study in the Netherlands.

Eur J Trauma Emerg Surg 2020 Jun 6. Epub 2020 Jun 6.

Department of Surgery, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.

Purpose: Rib fractures following thoracic trauma are frequently encountered injuries and associated with a significant morbidity and mortality. The aim of this study was to provide current data on the epidemiology, in-hospital outcomes and 30-day mortality of rib fractures, and to evaluate these results for different subgroups.

Methods: A nationwide retrospective cohort study was performed with the use of the Dutch Trauma Registry which covers 99% of the acutely admitted Dutch trauma population. Read More

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http://dx.doi.org/10.1007/s00068-020-01412-2DOI Listing

Chest wall stabilization with intercostal -suture and mesh for rib fractures.

Trauma Case Rep 2020 Aug 22;28:100311. Epub 2020 May 22.

Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Japan.

Choosing an optimal procedure to stabilize the chest wall for multiple rib fractures can be challenging for surgeons. Stabilization with rib plates or intramedullary devices requires exposure of fractured bones, whereas chest stabilization with intercostal -suture and mesh does not, yet it offers the chest wall a sufficient level of stability. Here, we report a case of a flail chest due to multiple rib fractures for which a simple chest wall fixation using intercostal -suture and mesh was efficient. Read More

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http://dx.doi.org/10.1016/j.tcr.2020.100311DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7256319PMC

Chylothorax caused by blunt trauma: Case review and management proposal.

Trauma Case Rep 2020 Aug 21;28:100308. Epub 2020 May 21.

Department of Surgery, St. Luke's Hospital of Kansas City, MO, United States of America.

Chylothorax is a potentially devastating complication of lymphatic trauma of the thorax. To date, no recommendations have provided decision making support for prompt definitive treatment. We present a 53 year old male involved in a motor vehicle collision sustaining 9 left rib fractures with flail segments. Read More

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http://dx.doi.org/10.1016/j.tcr.2020.100308DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7256325PMC

Blunt trauma related chest wall and pulmonary injuries: An overview.

Chin J Traumatol 2020 Jun 20;23(3):125-138. Epub 2020 Apr 20.

Gulhane Medical School, University of Health Sciences, Ankara, Turkey.

Physical traumas are tragic and multifaceted injuries that suddenly threaten life. Although it is the third most common cause of death in all age groups, one out of four trauma patients die due to thoracic injury or its complications. Blunt injuries constitute the majority of chest trauma. Read More

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http://dx.doi.org/10.1016/j.cjtee.2020.04.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7296362PMC

Successful surgical treatment of Cronkhite-Canada Syndrome with bilateral flail chest: a case report.

BMC Surg 2020 May 13;20(1):103. Epub 2020 May 13.

Department of Thoracic Surgery, First Hospital of Jilin University, No. 71, Xinmin Street, Changchun, Jilin, People's Republic of China.

Background: Development of multiple rib fractures leading to bilateral flail chest in Cronkhite-Canada Syndrome (CCS) has not been reported.

Case Presentation: A 59-year-old man presented with complaints of fatigue, chest pain, respiratory distress and orthopnea requiring ventilatory support to maintain oxygenation. CCS with bilateral anterior and posterior flail chest due to multiple rib fractures (2nd-10th on the right side and 2nd-11th on the left side). Read More

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http://dx.doi.org/10.1186/s12893-020-00766-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7222535PMC

Stability of Surgical Rib Fixation Hardware after Repeat Chest Trauma.

J Emerg Trauma Shock 2020 Jan-Mar;13(1):84-87. Epub 2020 Mar 19.

Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.

Surgical management of rib fractures has long been a controversial topic, but improvements in rib plating technology have led to a recent increase in interest among surgeons. Unfortunately, follow-up data are limited in patients following rib fracture plating. We present a unique case of an adult male who had multiple ribs plated for symptomatic rib fracture nonunions and developed periprosthetic fractures following repeat trauma several months later. Read More

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http://dx.doi.org/10.4103/JETS.JETS_67_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204963PMC

Unilateral Bilevel Erector Spinae Plane Catheters for Flail Chest: A Case Report.

A A Pract 2020 May;14(7):e01211

From the Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, Kentucky.

Providing effective analgesia for acute rib fractures is crucial in avoiding pulmonary complications. Erector spinae plane (ESP) block is an alternative treatment option to neuraxial techniques. ESP blocks have demonstrated pain relief in patients with rib fractures. Read More

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http://dx.doi.org/10.1213/XAA.0000000000001211DOI Listing

Combining the use of Nuss procedure and rib fixation for severe flail chest: a case report.

BMC Surg 2020 May 5;20(1):87. Epub 2020 May 5.

Department of Thoracic Surgery, Shenzhen Hospital, Southern Medical University, No.1333, Xinhu Road, Bao'an District, Shenzhen, 518101, Guangdong, China.

Background: Severe flail chest is a life-threatening situation. The Nuss procedure is a new effective treatment for severe flail chest patients who cannot be weaned from prolonged mechanical ventilation in the last few years. However, the procedure is not suitable when there are multiple fractures in both the anterior and lateral chest walls. Read More

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http://dx.doi.org/10.1186/s12893-020-00747-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7201783PMC

Surgical Stabilization of Rib Fractures during the COVID-19 Pandemic.

J Trauma Acute Care Surg 2020 Apr 16. Epub 2020 Apr 16.

P.I., CWIS NON-FLAIL, Denver Health Medical Center, Denver, CO UNITED STATES, President, Chest Wall Injury Society, University of Pennsylvania School of Medicine,

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http://dx.doi.org/10.1097/TA.0000000000002751DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202116PMC

Use of Closed Incision Negative Pressure Therapy for Massive Subcutaneous Emphysema.

Cureus 2020 Mar 24;12(3):e7399. Epub 2020 Mar 24.

Orthopaedic Surgery, Grant Medical Center, Columbus, USA.

Subcutaneous emphysema is typically due to an air leak through the parietal pleura, allowing air to escape from the lung parenchyma into the adjacent soft tissue. Most cases are benign and self-limiting; however, when enough air is forced into the subcutaneous tissues allowing the air to spread into the neck, tracheal compression and respiratory distress can occur. Tube thoracotomy and endotracheal intubation are generally sufficient to overcome this respiratory compromise. Read More

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http://dx.doi.org/10.7759/cureus.7399DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7179988PMC

Surgical fixation of rib fractures decreases intensive care length of stay in flail chest patients.

Ann Transl Med 2020 Mar;8(5):216

Department of Thoracic Surgery, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai 201700, China.

Background: Nonoperative treatment is currently the standard therapy for rib fractures. However, there is a trend towards surgical fixation from conservative management over the last decade. While surgical fixation of rib fractures has shown promising results, its impact on the clinical results remains unclear based on the current literature. Read More

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http://dx.doi.org/10.21037/atm.2020.01.39DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7154414PMC

Complications and Outcome after Rib Fracture Fixation: A Systematic Review.

J Trauma Acute Care Surg 2020 Apr 8. Epub 2020 Apr 8.

Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands Department of Orthopaedic Surgery, Harvard Medical School Orthopedic Trauma Initiative, Massachusetts General Hospital, Boston, United States of America. Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands Department of Orthopaedic Surgery, Harvard Medical School Orthopedic Trauma Initiative, Massachusetts General Hospital, Boston, United States of America. Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands Department of Orthopedic and Trauma Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.

Background: In recent years, there has been a growing interest in operative treatment for multiple rib fractures and flail chest. However, to date, there is no comprehensive study that extensively focused on the incidence of complications associated with rib fracture fixation. Furthermore, there is insufficient knowledge about the short- and long-term outcomes after rib fracture fixation. Read More

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http://dx.doi.org/10.1097/TA.0000000000002716DOI Listing

Association Between Adherence to Evidence-Based Practices for Treatment of Patients With Traumatic Rib Fractures and Mortality Rates Among US Trauma Centers.

JAMA Netw Open 2020 Mar 2;3(3):e201316. Epub 2020 Mar 2.

Institute for Health Informatics, University of Minnesota Academic Health Center, Minneapolis.

Importance: Rib fractures are sustained by nearly 15% of patients who experience trauma and are associated with significant morbidity and mortality. Evidence-based practice (EBP) rib fracture management guidelines and treatment algorithms have been published. However, few studies have evaluated trauma center adherence to EBP or the clinical outcomes of each practice within a national cohort. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2020.1316DOI Listing

ISCCM Guidelines for the Use of Non-invasive Ventilation in Acute Respiratory Failure in Adult ICUs.

Indian J Crit Care Med 2020 Jan;24(Suppl 1):S61-S81

Department of Division of Critical Care Medicine, Department of Anaesthesia, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India, , e-mail:

A. ACUTE HYPERCAPNIC RESPIRATORY FAILURE A1. Acute Exacerbation of COPD: Recommendations: NIV should be used in management of acute exacerbation of COPD in patients with acute or acute-on-chronic respiratory acidosis (pH = 7. Read More

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http://dx.doi.org/10.5005/jp-journals-10071-G23186DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7085817PMC
January 2020

Rib fixation in geriatric trauma: Mortality benefits for the most vulnerable patients.

J Trauma Acute Care Surg 2020 Jul;89(1):103-110

From the Department of Surgery, New York Presbyterian/Queens, Weill Cornell Medical College, Flushing, New York.

Background: Rib fractures in the geriatric trauma population are associated with significant morbidity and mortality. The outcomes of surgical stabilization of rib fractures (SSRF) have not been well defined in this population.

Methods: Data from the 2016 to 2017 Trauma Quality Improvement Program database were analyzed. Read More

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http://dx.doi.org/10.1097/TA.0000000000002666DOI Listing
July 2020
1.970 Impact Factor

Conquering the pneumococcal nemesis with oral antibiotics.

J Community Hosp Intern Med Perspect 2020 10;10(1):65-68. Epub 2020 Feb 10.

Department of Cardiology, St. Joseph's University, New York Medical College, Paterson, NJ, USA.

: endocarditis (SPE) occurs in <3% of all EI cases due to the evolution of penicillin and vaccination. However, immunocompromised and unvaccinated patients are still at grave risk. : A 58-year-old African American male who used alcohol and intravenous (IV) drugs presented with confusion, fever, and hemoptysis. Read More

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http://dx.doi.org/10.1080/20009666.2019.1708637DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034445PMC
February 2020

Thoracic dog bite wounds in dogs: A retrospective study of 123 cases (2003-2016).

Vet Surg 2020 May 20;49(4):694-703. Epub 2020 Feb 20.

Soft Tissue Surgery Service, Clinical Science and Services, Royal Veterinary College, London, United Kingdom.

Objective: To report the clinical, radiographic, and surgical findings and determine prognostic factors for outcome in dogs with thoracic dog bite wounds.

Study Design: Retrospective study.

Animals: Client-owned dogs (n = 123). Read More

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http://dx.doi.org/10.1111/vsu.13402DOI Listing

Sternochondral replacement: use of cadaveric allograft for the reconstruction of anterior chest wall.

J Thorac Dis 2020 Jan;12(1):3-9

Thoracic Surgery Unit, University Hospital of Padova, Padova, Italy.

Background: Sternum may be involved by different diseases such as trauma, infection after cardiac surgery, tumors (primary and secondary) or chest wall deformities. Surgical excision with a safety margin is the primary goal after sternal resection for tumors, prevention of respiratory impairment due to flail chest and deformity and protection of surrounding organs are other important aims. Various techniques and materials have been used for this operation. Read More

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http://dx.doi.org/10.21037/jtd.2019.07.82DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995821PMC
January 2020

[Flail chest in pediatric patient. Case report].

Arch Argent Pediatr 2020 02;118(1):e57-e60

Sanatorio Allende, Córdoba, Argentina.

Flail chest is defined by fracture of 3 or more adjacent ribs, at 2 or more sites, with paradoxical movement of the affected chest. It occurs in 2 to 4 % of blunt chest trauma, with a mortality of 10 to 15 %. Treatment is conservative, using analgesia and positive pressure ventilation, or surgical osteosynthesis of rib fractures. Read More

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http://dx.doi.org/10.5546/aap.2020.e57DOI Listing
February 2020

Testing the clinical validity of the Bemelman Rib Fracture Management Guideline.

Interact Cardiovasc Thorac Surg 2020 04;30(4):597-599

Department of Cardiothoracic Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.

Whilst surgical stabilization of rib fractures (SSRF) results in better outcomes, selection algorithms are lacking. We aimed to validate the Rib Fracture Management Guideline proposed by Bemelman. From a cohort of 792 patients with multiple rib fractures, 2 sequential cohorts were selected: 48 patients who underwent SSRF and 48 patients who managed conservatively. Read More

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http://dx.doi.org/10.1093/icvts/ivz317DOI Listing

Predicting the need for tracheostomy in trauma patients without severe head injury.

Am J Surg 2020 Aug 20;220(2):495-498. Epub 2019 Dec 20.

Department of Surgery, Westchester Medical Center, New York Medical College, 100 Woods Road, Taylor Pavilion, Office Suite #353, Valhalla, NY, 10595, USA. Electronic address:

Background: Early tracheostomy is recommended in patients with severe traumatic brain injury (TBI); however, predicting the timing of tracheostomy in trauma patients without severe TBI can be challenging.

Methods: A one year retrospective analysis of all trauma patients who were admitted to intensive Care Unit for > 7 days was performed, using the ACS-TQIP database. Univariate and Multivariate regression analyses were performed to assess the appropriate weight of each factor in determining the eventual need for early tracheostomy. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2019.12.018DOI Listing
August 2020
2.291 Impact Factor

Current status and research progress of minimally invasive surgery for flail chest.

Exp Ther Med 2020 Jan 2;19(1):421-427. Epub 2019 Dec 2.

Department of Cardiothoracic Surgery, Tianjin Hospital Affiliated to Tianjin University, Tianjin 300000, P.R. China.

Chest trauma accounts for ~13.5% of all traumas, and direct death from chest trauma accounts for 20-25% of all traumatic deaths. Chest trauma is the second cause of death from trauma. Read More

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http://dx.doi.org/10.3892/etm.2019.8264DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6913304PMC
January 2020

[Early Sternum Fixation with a Locking Plate for Traumatic Sternal Fracture].

Kyobu Geka 2019 Dec;72(13):1076-1079

Department of Respiratory Surgery, Kure Medical Center and Chugoku Cancer Center, Kure, Japan.

An 86-year-old man fell from a farm trolley and presented with chest bruising. Chest computed tomography showed a hemopneumothorax, multiple right rib fractures, and a sternal fracture at the sternal angle. Although he was treated with a chest tube for drainage and external fixation, a flail chest and severe pain continued. Read More

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December 2019

An unexpected fracture of a titanium rib plate in a patient with traumatic brain injury.

Trauma Case Rep 2019 Dec 31;24:100254. Epub 2019 Oct 31.

Department of Thoracic and Cardiovascular Surgery, Dankook University Hospital, Cheonan, Republic of Korea.

Surgical stabilization of rib fractures has been accepted and successfully performed for the management of patients with multiple rib fractures. Several types of devices, such as titanium bar, plate, and screws, are used for rib stabilization. Titanium devices provide a strong support for rib fixation and chest wall reconstruction and are rarely associated with complications. Read More

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http://dx.doi.org/10.1016/j.tcr.2019.100254DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6911856PMC
December 2019

Treatment for Anterior Flail Chest With a Vacuum Bell.

Ann Thorac Surg 2020 Jul 17;110(1):e55-e57. Epub 2019 Dec 17.

Department of Thoracic and Endocrine Surgery, University Hospital of Grenoble, Grenoble, France.

We describe a patient with polytrauma that included anterior chest flail caused by a fall while climbing. As the situation was similar to a pectus excavatum, we attempted to stabilize the depressed chest wall by using a vacuum bell. Deep breath, peak flow, and pectus index were increased when the patient used the vacuum bell. Read More

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http://dx.doi.org/10.1016/j.athoracsur.2019.10.065DOI Listing

Risk factors for pneumonia following rib fractures.

Am J Emerg Med 2020 03 18;38(3):610-612. Epub 2019 Nov 18.

Department of Surgery, Wright State University Boonshoft School of Medicine, Dayton, OH, United States.

Introduction: Pneumonia is a known complication following rib fractures. This study was undertaken to identify clinical and demographic factors associated with the development of pneumonia among trauma patients with rib fractures.

Methods: This retrospective study examined trauma patients with one or more rib fractures, who were admitted for inpatient management during the time period 2012 through 2017. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.10.021DOI Listing

A multicenter, prospective, controlled clinical trial of surgical stabilization of rib fractures in patients with severe, nonflail fracture patterns (Chest Wall Injury Society NONFLAIL).

J Trauma Acute Care Surg 2020 Feb;88(2):249-257

From the Department of Surgery, Division of Trauma, Denver Health Medical Center (F.M.P., K.L.), Denver Colorado; Department of Surgery, Division of Trauma, University of Nebraska Medical Center (Z.B.), Omaha, Nebraska; Department of Surgery, Division of Trauma, Medical University of South Carolina (E.A.E.), Charleston, South Carolina; Department of Surgery, Division of Trauma, St. Mary's Medical Center (L.L.), West Palm Beach, Florida; Department of Surgery, Division of Trauma, Intermountain Medical Center (S.M.), Murray, Utah; Department of Surgery, Division of CT Surgery, St. Joseph Health (L.P.), Mission Hospital, Mission Viejo, California; Department of Surgery, Division of Trauma, George Washington University (B.S.), Washington, District of Columbia; Department of Surgery, Division of Trauma, Wright State University/Miami Valley Hospital (G.S.), Dayton, Ohio; Department of Surgery, Division of Trauma, Carolinas Medical Center (B.T.), Charlotte, North Carolina; Department of Surgery, Division of Trauma, The Queens Medical Center (F.Z.), Honolulu, Hawaii; Department of Surgery, Division of Trauma, Sanford Health (C.D.), Fargo, North Dakota; Department of Surgery, Division of Trauma, Baystate Medical Center (A.R.D.), Springfield, Massachusetts.

Background: The efficacy of surgical stabilization of rib fracture (SSRF) in patients without flail chest has not been studied specifically. We hypothesized that SSRF improves outcomes among patients with displaced rib fractures in the absence of flail chest.

Methods: Multicenter, prospective, controlled, clinical trial (12 centers) comparing SSRF within 72 hours to medical management. Read More

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http://dx.doi.org/10.1097/TA.0000000000002559DOI Listing
February 2020

Surgical treatment ofpatients with severe non-flail chest rib fractures.

World J Clin Cases 2019 Nov;7(22):3718-3727

Department of Thoracic Surgery, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, China.

Background: Many patients have inadequate long-term analgesia, respiratory distress, and hypoxemia due to a long-standing substantial smoking history or the presence of primary pulmonary diseases; analgesic treatment is not valid in these patients. Even if the imaging findings of rib fractures are relatively mild, rib fractures may cause severe position limitation, respiratory distress, and hypoxemia.

Aim: To investigate the curative effect of surgical treatment for patients with severe non-flail chest rib fractures. Read More

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http://dx.doi.org/10.12998/wjcc.v7.i22.3718DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6887616PMC
November 2019

Surgical Stabilization of Rib Fractures in a Patient with Empyema: A Case Report.

JBJS Case Connect 2019 Dec;9(4):e0202

Department of Surgery, Center for Trauma and Critical Care, George Washington University, Washington, DC.

Case: A patient sustained flail chest and diaphragmatic rupture with perforation of the stomach. She underwent gastrorrhaphy with chest lavage. She developed empyema and underwent decortication. Read More

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http://dx.doi.org/10.2106/JBJS.CC.19.00202DOI Listing
December 2019

The evaluation of pulmonary function after rib fixation for multiple rib fractures and flail chest: a retrospective study and systematic review of the current evidence.

Eur J Trauma Emerg Surg 2019 Nov 25. Epub 2019 Nov 25.

Department of Orthopedic and Trauma Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland.

Purpose: The primary aim of this retrospective cohort study was to evaluate the pulmonary function after rib fixation for patients with multiple rib fractures and flail chest. Secondary, a systematic review was performed to give an overview of the current literature and to allow comparison with our results.

Methods: All adult (≥ 18 years) patients who underwent rib fixation for multiple rib fractures or flail chest between 2010 and 2018 and who received a control pulmonary function test during the postoperative follow-up at our level-1 trauma center were retrospectively reviewed. Read More

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http://dx.doi.org/10.1007/s00068-019-01274-3DOI Listing
November 2019

Epidemiology of adult rib fracture and factors associated with surgical fixation: Analysis of a chest wall injury dataset from England and Wales.

Injury 2020 Feb 15;51(2):218-223. Epub 2019 Oct 15.

York Trials Unit, Department of Health Sciences, ARRC Building, University of York, Heslington, York, YO10 5DD. Electronic address:

Introduction: Chest wall trauma is commonly seen in patients admitted with both high and low-energy transfer injury. Whilst often associated with other injuries, it is also seen in isolation following simple falls in the older patient. Fixation of the chest wall grows in popularity as part of optimising patient care, particularly in terms of critical care stay. Read More

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http://dx.doi.org/10.1016/j.injury.2019.10.030DOI Listing
February 2020
3 Reads

A case of severe flail chest with several dislocated sterno-chondral fractures.

Int J Surg Case Rep 2019 28;65:52-56. Epub 2019 Oct 28.

Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, DK - 8200 Aarhus N, Denmark; Department of Clinical Medicine, Aarhus University Hospital, DK - 8200 Aarhus N, Denmark.

Introduction: Flail chest is diagnosed clinically by the presence of paradox movement of a segment of the thoracic wall during spontaneous breathing. Radiographic finding confirming a clinical flail chest are fractures of three or more consecutive ribs or costal cartilages in two or more places. Surgical stabilization is associated with a reduced length of hospital stay, time with mechanical ventilation and risk of respiratory complications. Read More

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http://dx.doi.org/10.1016/j.ijscr.2019.10.043DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6838885PMC
October 2019

Determining the clinical significance of the Chest Wall Injury Society taxonomy for multiple rib fractures.

J Trauma Acute Care Surg 2019 12;87(6):1282-1288

From the Department of Cardiothoracic Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Sheffield, United Kingdom.

Background: The Chest Wall Injury Society (CWIS) proposals for standardized nomenclature for multiple rib fracture (MRF) classifications were derived by international expert Delphi consensus. This study aimed to validate the CWIS taxonomy using a single-instituion clinical database.

Methods: Computed tomography (CT) scans, of 539 consecutive patients with MRFs admitted to a regional major trauma center over a 33-month period, were reviewed (blinded for clinical outcomes). Read More

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http://dx.doi.org/10.1097/TA.0000000000002519DOI Listing
December 2019

Bilateral Floating Knee Injury-Management of a Complex Injury.

J Long Term Eff Med Implants 2019 ;29(1):1-6

Trauma and Orthopaedic Department, Prince Charles Hospital, London, UK.

Floating knee is a flail knee joint resulting from fractures of the shafts or adjacent metaphyses of the femur and ipsilateral tibia. Floating knee injuries may include a combination of diaphyseal, metaphyseal, and intra-articular fractures. Floating knee injuries are a group of complex injuries that require a careful assessment. Read More

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http://dx.doi.org/10.1615/JLongTermEffMedImplants.2019030557DOI Listing
January 2019

Quantifying Pain Associated With Rib Fractures.

J Surg Res 2020 02 24;246:476-481. Epub 2019 Oct 24.

Division of Trauma, Surgical Critical Care, and Acute Care Surgery, Department of Surgery, University of Arizona, Phoenix, Arizona.

Introduction: Rib fractures are a major problem in trauma patients, and the associated pain is not well understood. Measuring total pain experience, duration, and intensity could facilitate comparisons of treatments. This study was intended to evaluate the feasibility of quantifying pain over the course of an admission and identify factors associated with increased pain experience in adults with rib fractures. Read More

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http://dx.doi.org/10.1016/j.jss.2019.09.032DOI Listing
February 2020
1 Read

Anterior Middle Chest Wall Reconstruction Using a Free Anterolateral Thigh Flap Resulted in Flail Chest: A Case Report.

Plast Reconstr Surg Glob Open 2019 Aug 19;7(8):e2386. Epub 2019 Aug 19.

Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Supplemental Digital Content is available in the text. Read More

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http://dx.doi.org/10.1097/GOX.0000000000002386DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6756648PMC
August 2019
1 Read

Successfully non-surgical management of flail chest as first manifestation of multiple myeloma: A case report.

World J Crit Care Med 2019 Sep 11;8(5):82-86. Epub 2019 Sep 11.

Department of Critical Care, Hospital del Mar, Barcelona 08003, Spain.

Background: Multiple myeloma is a malignant neoplasm of the bone marrow characterized by neoplastic proliferation of monoclonal plasma cells with a high relationship with destructive bone disease. We present a case of a patient diagnosed with multiple myeloma and sternal fracture in association with multiple bilateral rib fractures and thoracic kyphosis, who developed a severe acute respiratory failure, thus complicating the initial presentation of multiple myeloma. We discuss the therapeutic implications of this uncommon presentation. Read More

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http://dx.doi.org/10.5492/wjccm.v8.i5.82DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6753394PMC
September 2019
5 Reads

Multicentre prospective cohort study of nonoperative versus operative treatment for flail chest and multiple rib fractures after blunt thoracic trauma: study protocol.

BMJ Open 2019 08 27;9(8):e023660. Epub 2019 Aug 27.

Trauma Surgery, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands.

Introduction: A trend has evolved towards rib fixation for flail chest although evidence is limited. Little is known about rib fixation for multiple rib fractures without flail chest. The aim of this study is to compare rib fixation with nonoperative treatment for both patients with flail chest and patients with multiple rib fractures. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-023660DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6720131PMC
August 2019
2 Reads

Early Versus Late Tracheostomy in Trauma Patients With Rib Fractures.

J Surg Res 2020 01 8;245:72-80. Epub 2019 Aug 8.

Division of Trauma and Critical Care Services, Delray Medical Center, Delray Beach, Florida; Division of Trauma and Critical Care Services, Broward Health Medical Center, Fort Lauderdale, Florida; Department of Surgery, Florida Atlantic University, Charles E. Schmidt College of Medicine, Boca Raton, Florida; Department of Surgery, Florida International University, Herbert Wertheim College of Medicine, Miami, Florida.

Background: Patients with blunt chest trauma with multiple rib fractures (RF) may require tracheostomy. The goal was to compare early (≤7 d) versus late (>7 d) tracheostomy patients and to analyze clinical outcomes, to determine which timing is more beneficial.

Methods: This retrospective review included 124 patients with RF admitted to trauma ICU at two level 1 trauma centers who underwent tracheostomy. Read More

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http://dx.doi.org/10.1016/j.jss.2019.07.023DOI Listing
January 2020
3 Reads

Early fixation versus conservative therapy of multiple, simple rib fractures (FixCon): protocol for a multicenter randomized controlled trial.

World J Emerg Surg 2019 30;14:38. Epub 2019 Jul 30.

1Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.

Background: Multiple rib fractures are common injuries in both the young and elderly. Rib fractures account for 10% of all trauma admissions and are seen in up to 39% of patients after thoracic trauma. With morbidity and mortality rates increasing with the number of rib fractures as well as poor quality of life at long-term follow-up, multiple rib fractures pose a serious health hazard. Read More

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http://dx.doi.org/10.1186/s13017-019-0258-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6668138PMC
April 2020
8 Reads

Management of traumatic flail chest in intensive care unit: An experience from trauma center ICU.

Saudi J Anaesth 2019 Jul-Sep;13(3):179-183

Department of General Surgery, Trauma Centre, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

Background/aim: The thoracic injury and related complications are responsible for upto 25% of blunt trauma mortality. This study is designed to compare these two popular ventilation modes in traumatic flail chest.

Materials And Method: A total of 30 patients with thoracic trauma, aged 18-60 years, were enrolled in this study for a period of 1 year. Read More

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http://dx.doi.org/10.4103/sja.SJA_699_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6625290PMC
July 2019
2 Reads

Predictors of mortality in patients with rib fractures.

Eur J Trauma Emerg Surg 2019 Jul 19. Epub 2019 Jul 19.

Department of Surgery, New York Medical College, Valhalla, NY, USA.

Background: The aim of this study was to identify risk factors for morbidity and mortality in patients with rib fractures with focus on identifying a more exact age-dependent cut-off for increased morbidity and mortality.

Methods: Retrospective study of patients 16 years or older with rib fractures from blunt trauma.

Exclusion Criteria: patients undergoing rib plating. Read More

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http://dx.doi.org/10.1007/s00068-019-01183-5DOI Listing
July 2019
3 Reads

A Statewide Assessment of Rib Fixation Patterns Reveals Missed Opportunities.

J Surg Res 2019 12 9;244:205-211. Epub 2019 Jul 9.

Division of Traumatology, Surgical Critical Care & Emergency Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address:

Background: Rib fractures are a common consequence of traumatic injury and can result in significant debilitation. Rib fixation offers fracture stabilization, resulting in improved outcomes and decreased pulmonary complications, especially in high-risk groups such as those with flail segments. However, commercial rib fixation has only recently become clinically prevalent, and we hypothesize that significant variability exists in its utilization based on injury pattern and trauma center. Read More

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http://dx.doi.org/10.1016/j.jss.2019.06.048DOI Listing
December 2019
3 Reads

Blunt chest trauma: classification and management.

Emerg Radiol 2019 Oct 6;26(5):557-566. Epub 2019 Jul 6.

Sunnybrook Health Sciences Centre, Toronto, Canada.

Blunt chest wall injuries are a significant cause of mortality and morbidity in trauma patients. Accurate identification and description of chest wall injuries by the radiologist can aid in guiding proper patient management. The American Association for the Surgery of Trauma (AAST) has devised a classification system based on severity. Read More

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http://dx.doi.org/10.1007/s10140-019-01705-zDOI Listing
October 2019
2 Reads

[Surgery for Flail Chest with Titanium Plates after Cardiopulmonary Resuscitation;Report of a Case].

Kyobu Geka 2019 Apr;72(4):318-320

Department of Thoracic Surgery, Hakodate Municipal Hospital, Hakodate, Japan.

A 74-year-old woman was admitted for the management of nausea with hyponatremia. On the 19th day of hospitalization, the patient developed cardiac arrest and needed cardiopulmonary resuscitation (CPR). CPR was successful but the patient developed multiple rib fractures with flail chest by CPR. Read More

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April 2019
3 Reads

Efficacy of nickel-titanium memory alloy in the treatment of multiple rib fracture combined with sternal fracture.

Exp Ther Med 2019 Jul 22;18(1):537-542. Epub 2019 May 22.

Department of Thoracic Surgery, Xuzhou Central Hospital, Xuzhou, Jiangsu 221000, P.R. China.

Clinical efficacy and complications of nickel-titanium memory alloy in the treatment of multiple rib fractures combined with sternal fractures was investigated. A retrospective analysis of 123 patients with multiple rib fractures combined with sternal fractures admitted to First People's Hospital of Fuzhou from January 2013 to December 2015 was performed, including study group (treated with internal fixation by the nickel-titanium memory alloy, n=68) and control group (treated with internal fixation by partial pressure bandage, n=55). Μean arterial pressure (MAP), heart rate (HR), and visual analogue pain score (VAS) of the two groups before and after treatment were compared and analyzed. Read More

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http://dx.doi.org/10.3892/etm.2019.7597DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6566122PMC
July 2019
7 Reads

Functional Outcomes After Muscle-Sparing Fixation of Flail Chest Injuries.

J Orthop Trauma 2019 Jul;33(7):366-369

Department of Orthopaedic Surgery, Mount Carmel Medical Center, Columbus, OH.

Objectives: To present outcomes in a multicenter review of a large number of flail chest patients.

Design: Retrospective case series.

Setting: One urban Level I and 1 urban Level II trauma center. Read More

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http://dx.doi.org/10.1097/BOT.0000000000001456DOI Listing
July 2019
18 Reads

The ideal methods for the management of rib fractures.

J Thorac Dis 2019 May;11(Suppl 8):S1078-S1089

Department of Thoracic Surgery, General Hospital of Southern Theater Command, PLA, Guangzhou 510010, China.

The clinical treatment choices for multiple rib fractures and flail chest are controversial. For example, among conservative treatment and surgical treatment, different studies have different conclusions and recommendations. Furthermore, early clinical research was mainly focused on the treatment of flail chest due to its severity. Read More

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http://dx.doi.org/10.21037/jtd.2019.04.109DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6545517PMC
May 2019
9 Reads