Indications for surgical stabilization of rib fractures in patients without flail chest: surveyed opinions of members of the Chest Wall Injury Society

2017 ◽  
Vol 42 (2) ◽  
pp. 401-408 ◽  
Author(s):  
Fredric M. Pieracci ◽  
Suresh Agarwal ◽  
Andrew Doben ◽  
Adam Shiroff ◽  
Larwence Lottenberg ◽  
...  
Keyword(s):  
Chest Wall ◽  
Flail Chest ◽  
Rib Fractures ◽  
Chest Wall Injury ◽  
Wall Injury

The Chest Wall Injury Society Recommendations for Reporting Studies of Surgical Stabilization of Rib Fractures

Injury ◽  
2021 ◽  
Author(s):  
Fredric M. Pieracci ◽  
Sebastian Schubl ◽  
Mario Gasparri ◽  
Patrick Delaplain ◽  
Jordan Kirsch ◽  
...  
Keyword(s):  
Chest Wall ◽  
Rib Fractures ◽  
Chest Wall Injury ◽  
Wall Injury

Decreased Incidence of Rib Fractures in Pregnant Patients After Motor Vehicle Collisions

2021 ◽  
Vol 30 (5) ◽  
pp. 385-390
Author(s):  
Marissa Di Napoli ◽  
William B. DeVoe ◽  
Stuart Leon ◽  
Bruce Crookes ◽  
Alicia Privette ◽  
...  
Keyword(s):  
Chest Wall ◽  
Injury Severity ◽  
Motor Vehicle ◽  
Rib Fractures ◽  
Hormonal Changes ◽  
Motor Vehicle Collisions ◽  
Vehicle Collisions ◽  
Vehicle Collision ◽  
Chest Wall Injury ◽  
Wall Injury

Background Rib fractures are common after motor vehicle collisions. The hormonal changes associated with pregnancy decrease the stiffness and increase the laxity of cartilage and tendons. The effect of these changes on injury mechanics is not completely understood. Objectives To compare the incidences of chest wall injury following blunt thoracic trauma between pregnant and nonpregnant women. Methods The authors conducted a retrospective review of female patients seen at a level I trauma center from 2009 to 2017 after a motor vehicle collision. Patient characteristics were compared to determine if pregnancy affected the incidence of chest wall injury. Statistics were calculated with SPSS version 24 and are presented as mean (SD) or median (interquartile range). Results In total, 1618 patients were identified. The incidence of rib/sternal fracture was significantly lower in pregnant patients (7.9% vs 15.2%, P = .047), but the incidence of intrathoracic injury was similar between the groups. Pregnant and nonpregnant patients with rib/sternal fractures had similar Injury Severity Score results (21 [13-27] vs 17 [11-22], P = .36), but pregnant patients without fractures had significantly lower scores (1 [0-5] vs 4 [1-9], P < .001). Conclusions Pregnant patients have a lower rate of rib fracture after a motor vehicle collision than nonpregnant patients. The difference in injury mechanics may be due to hormonal changes that increase elasticity and resistance to bony injury of the ribs. In pregnant trauma patients, intrathoracic injury without rib fracture should raise concerns about injury severity. A multicenter evaluation of these findings is needed.

Surgical stabilization of rib fractures after penetrating thoracic injury: A chest wall injury society multicenter study

2020 ◽  
Vol 5 (1) ◽  
pp. 11
Author(s):  
JodyM Kaban ◽  
JohnP Skendelas ◽  
ErinR Lewis ◽  
Babak Sarani ◽  
MauricioVelasquez Galvis ◽  
...  
Keyword(s):  
Chest Wall ◽  
Multicenter Study ◽  
Rib Fractures ◽  
Thoracic Injury ◽  
Chest Wall Injury ◽  
Wall Injury

scholarly journals Complications of clavicle fracture surgery in patients with concomitant chest wall injury: a retrospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Tsung-Han Yang ◽  
Huan-Jang Ko ◽  
Alban Don Wang ◽  
Wo-Jan Tseng ◽  
Wei-Tso Chia ◽  
...  
Keyword(s):  
Chest Wall ◽  
Hospital Readmission ◽  
Clavicle Fracture ◽  
Flail Chest ◽  
Fracture Repair ◽  
Rib Fractures ◽  
Readmission Rates ◽  
Hospital Readmission Rates ◽  
Chest Wall Injury ◽  
The Impact

Abstract Background The impact of associated chest wall injuries (CWI) on the complications of clavicle fracture repair is unclear to date. This study aimed to investigate the complications after surgical clavicle fracture fixation in patients with and without different degrees of associated CWI. Methods A retrospective review over a four-year period of patients who underwent clavicle fracture repair was conducted. A CWI and no-CWI group were distinguished, and the CWI group was subdivided into the minor-CWI (three or fewer rib fractures without flail chest) and complex-CWI (flail chest, four or more rib fractures) subgroup. Demographic data, classification of the clavicle fracture, number of rib fractures, and associated injuries were recorded. Overall complications included surgery-related complications and unplanned hospital readmissions. Univariate analysis and stepwise backward multivariate logistic regression were used to identify potential risk factors for complications. Results A total of 314 patients undergoing 316 clavicle fracture operations were studied; 28.7% of patients (90/314) occurred with associated CWI. Patients with associated CWI showed a significantly higher age, body mass index, and number of rib fractures. The overall and surgical-related complication rate were similar between groups. Unplanned 30-day hospital readmission rates were significantly higher in the complex-CWI group (p = 0.02). Complex CWI and number of rib fractures were both independent factor for 30-day unplanned hospital readmission (OR 1.59, 95% CI: 1.00–2.54 and OR 1.33, 95% CI: 1.06–1.68, respectively). Conclusion CWI did not affect surgery-related complications after clavicle fracture repair. However, complex-CWI may increase 30-day unplanned hospital readmission rates.

Rib Fractures and Chest Wall Injury

2020 ◽  
pp. 145-158
Author(s):  
Federico Coccolini ◽  
Michelle Hamel ◽  
Francesco Favi ◽  
John Mayberry
Keyword(s):  
Chest Wall ◽  
Rib Fractures ◽  
Chest Wall Injury ◽  
Wall Injury

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

2019 ◽  
Vol 87 (6) ◽  
pp. 1282-1288 ◽  
Author(s):  
Peter T.M. Clarke ◽  
Rosalind B. Simpson ◽  
Jessica R. Dorman ◽  
William J. Hunt ◽  
John G. Edwards
Keyword(s):  
Chest Wall ◽  
Clinical Significance ◽  
Rib Fractures ◽  
Multiple Rib Fractures ◽  
Chest Wall Injury ◽  
Wall Injury

scholarly journals Complication to consider: delayed traumatic hemothorax in older adults

2021 ◽  
Vol 6 (1) ◽  
pp. e000626
Author(s):  
Jeff Choi ◽  
Ananya Anand ◽  
Katherine D Sborov ◽  
William Walton ◽  
Lawrence Chow ◽  
...  
Keyword(s):  
Older Adults ◽  
Chest Wall ◽  
Descriptive Analysis ◽  
Chest Ct ◽  
Rib Fractures ◽  
Delayed Presentation ◽  
Injury Patterns ◽  
True Incidence ◽  
Chest Wall Injury ◽  
Wall Injury

BackgroundEmerging evidence suggests older adults may experience subtle hemothoraces that progress over several days. Delayed progression and delayed development of traumatic hemothorax (dHTX) have not been well characterized. We hypothesized dHTX would be infrequent but associated with factors that may aid prediction.MethodsWe retrospectively reviewed adults aged ≥50 years diagnosed with dHTX after rib fractures at two level 1 trauma centers (March 2018 to September 2019). dHTX was defined as HTX discovered ≥48 hours after admission chest CT showed either no or ‘minimal/trace’ HTX. Two blinded, board-certified radiologists reviewed inpatient chest imaging and classified injury patterns according to Chest Wall Injury Society (CWIS) taxonomy. Descriptive analysis was performed for demographic and hospitalization characteristics.ResultsWe identified 14 patients with pooled dHTX rate of 1.3%. After initial chest CT negative for concerning hemothoraces, the patients did not undergo follow-up imaging until new symptoms (shortness of breath, chest pain) developed: eight (57%) were not diagnosed until after discharge from initial hospitalization (mean (range): 9 (2–20) days after discharge). Aspirin and/or anticoagulants were involved in fewer than half of cases (43%). According to CWIS taxonomy, all patients had a series of posterolateral fractures with at least one offset or displaced fracture, and an average of six consecutive rib fractures. All patients underwent tube thoracostomy and six patients (42%)—all aged <65—underwent operative interventions.DiscussionPreliminary data suggest older adults with rib fractures may be at risk of experiencing delayed progression of trace hemothoraces or a delayed presentation of hemothoraces. Asymptomatic progression or readmission to other services/hospitals likely occurs and true dHTX rates are likely higher. Our preliminary findings suggest a possible anatomic explanation for severe chest wall injury patterns’ association with dHTX. Further characterization and capturing the true incidence of dHTX first requires wider recognition of this complication.

scholarly journals Outcomes of chest wall fixation in cardiopulmonary resuscitation-induced flail chest

2020 ◽  
Vol 31 (3) ◽  
pp. 417-418
Author(s):  
Oliver Claydon ◽  
Rachel Benamore ◽  
Elizabeth Belcher
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Chest Wall ◽  
Flail Chest ◽  
Common Complication ◽  
Primary Event ◽  
Rib Fixation ◽  
Chest Wall Injury ◽  
Wall Injury

Abstract Chest wall injury is a common complication of cardiopulmonary resuscitation. Chest wall fixation of flail chest has been shown to improve outcomes in patients in whom trauma is the primary pathology. Its efficacy in the post-cardiopulmonary resuscitation setting where the primary event is cardiac arrest is yet to be determined. We report outcomes in a series of 4 patients who underwent rib fixation in the setting of cardiopulmonary resuscitation-induced flail chest.

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