The surgical stabilization of multiple rib fractures using titanium elastic nail in blunt chest trauma with acute respiratory failure

Background Patient factors associated with delayed respiratory failure (DRF) after blunt chest trauma are not well documented. Earlier identification and closer monitoring may improve outcomes for these patients. The purpose of this study was to identify the prevalence and clinical predictors of DRF in patients after blunt chest trauma. Materials and Methods A retrospective review of adult patients admitted to a Level 1 trauma center after blunt chest trauma between January 1, 2009 and December 31, 2013, was conducted. Patients with early respiratory failure were compared to patients with DRF using Fisher’s exact tests, chi square, and Student’s t-tests. A P-value of <.05 was considered significant. Results 1299 patients had blunt chest trauma and at least 1 rib fracture, of which 830 met inclusion criteria. 5.8% of patients progressed to respiratory failure. Respiratory failure was delayed in 25% of these patients. DRF patients had significantly lower ISS (16.5 vs. 22.7, P = .04), more bilateral rib fractures (66.7% vs. 28.7%, P = .02) and fewer pulmonary contusions (16.7% vs. 50.0%, P = .04). Discussion Injury patterns, including bilateral rib fractures without pulmonary contusions and low but severe Injury Severity Score burden, may help identify high-risk patients who may benefit from closer monitoring and more aggressive therapy.

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Thoracic Paravertebral Analgesia for Treatment Blunt Chest Trauma with Multiple Rib Fractures

Journal of Clinical Trials ◽

10.4172/2167-0870.1000321 ◽

2017 ◽

Vol 07 (04) ◽

Author(s):

Nguyen Truong Giang ◽

Nguyen Van Nam ◽

Nguyen Ngoc Trung ◽

Le Viet Anh ◽

Nguyen Trung Kien

Keyword(s):

Blunt Chest Trauma ◽

Chest Trauma ◽

Rib Fractures ◽

Multiple Rib Fractures

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Acute Respiratory Failure in Severe Blunt Chest Trauma

Journal of Trauma and Acute Care Surgery ◽

10.1097/00005373-198203000-00008 ◽

1982 ◽

Vol 22 (3) ◽

pp. 221-226 ◽

Cited By ~ 50

Author(s):

J. C. PINILLA

Keyword(s):

Respiratory Failure ◽

Acute Respiratory Failure ◽

Blunt Chest Trauma ◽

Chest Trauma

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Noninvasive positive pressure ventilation in patients with blunt chest trauma and acute respiratory failure

Critical Care ◽

10.1186/cc1086 ◽

2001 ◽

Vol 5 (Suppl 1) ◽

pp. P016

Author(s):

S Milanov ◽

M Milanov

Keyword(s):

Respiratory Failure ◽

Acute Respiratory Failure ◽

Blunt Chest Trauma ◽

Chest Trauma ◽

Positive Pressure Ventilation ◽

Noninvasive Positive Pressure Ventilation ◽

Positive Pressure

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Epidemiology of combined clavicle and rib fractures: a systematic review

European Journal of Trauma and Emergency Surgery ◽

10.1007/s00068-021-01701-4 ◽

2021 ◽

Author(s):

Arthur A. R. Sweet ◽

Reinier B. Beks ◽

Frank F. A. IJpma ◽

Mirjam B. de Jong ◽

Frank J. P. Beeres ◽

...

Keyword(s):

Systematic Review ◽

Length Of Stay ◽

Blunt Chest Trauma ◽

Chest Trauma ◽

Rib Fractures ◽

Hospital Length Of Stay ◽

Trauma Patients ◽

Multiple Rib Fractures ◽

Polytrauma Patients ◽

Clavicle Fractures

Abstract Purpose The aim of this systematic review was to provide an overview of the incidence of combined clavicle and rib fractures and the association between these two injuries. Methods A systematic literature search was performed in the MEDLINE, EMBASE, and CENTRAL databases on the 14th of August 2020. Outcome measures were incidence, hospital length of stay (HLOS), intensive care unit admission and length of stay (ILOS), duration of mechanical ventilation (DMV), mortality, chest tube duration, Constant–Murley score, union and complications. Results Seven studies with a total of 71,572 patients were included, comprising five studies on epidemiology and two studies on treatment. Among blunt chest trauma patients, 18.6% had concomitant clavicle and rib fractures. The incidence of rib fractures in polytrauma patients with clavicle fractures was 56–60.6% versus 29% in patients without clavicle fractures. Vice versa, 14–18.8% of patients with multiple rib fractures had concomitant clavicle fractures compared to 7.1% in patients without multiple rib fractures. One study reported no complications after fixation of both injuries. Another study on treatment, reported shorter ILOS and less complications among operatively versus conservatively treated patients (5.4 ± 1.5 versus 21 ± 13.6 days). Conclusion Clavicle fractures and rib fractures are closely related in polytrauma patients and almost a fifth of all blunt chest trauma patients sustain both injuries. Definitive conclusions could not be drawn on treatment of the combined injury. Future research should further investigate indications and benefits of operative treatment of this injury.

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Correlation between Rib Fractures and Intra-abdominal Organ Injuries after Blunt Chest Trauma.

Albanian Journal of Trauma and Emergency Surgery ◽

10.32391/ajtes.v4i2.145 ◽

2020 ◽

Vol 4 (2) ◽

pp. 671-677

Author(s):

Agron DOGJANI ◽

Kastriot HAXHIREXHA ◽

Henri KOLANI ◽

Edvin SELMANI ◽

Arben GJATA ◽

...

Keyword(s):

Blunt Chest Trauma ◽

Chest Trauma ◽

Treatment Options ◽

Population Sample ◽

Rib Fractures ◽

University Hospital ◽

Abdominal Organ ◽

Abdominal Injuries ◽

Multiple Rib Fractures ◽

Intraabdominal Injuries

Introduction; The most common thoracic injuries were rib fractures (40%) and simple lung contusions (35%) and the abdominal organs most commonly injured were the spleen (35%), liver (25%), and kidney (20%). Mortality varies from 3-22%. the thoracic-abdominal injuries, Purpose; Evidence of the role of thoracic trauma in intraabdominal injuries. Evaluation of correlation between rib fractures and intra-abdominal organ injuries after Blunt Chest Trauma; Materials and methods; The study has a retrospective character, conducted within the period of December 2017 - June 2019. In our study, 890 patients were included in the Emergency Department at University Hospital of Trauma, Tirana, Albania. The population sample was selected randomly without any study restrictions. Results; Our study includes 890 patients; distribution of gender-based was: 196 (22%) females and 694 (78%) males. The distribution based on age: 116 (13 %); for <14 years old group; 347 (39%); for 14-40 years old; 427 (48%).for >40 years old. Conclusions; In Blunt Chest trauma, the incidence of intraabdominal organ injuries is high as evidenced by our study. All patients with such injuries should be evaluated and evaluated until the possibility of such intra-abdominal damage is ruled out. Also, intra-abdominal injuries in multiple rib fractures patients with more than 6 fractures show high gravity, full inspection and observation must be achieved to prepare for possible emergency surgery or other treatment options.

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