multiple rib fractures
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2021 ◽  
Author(s):  
Mehmet Gunay ◽  
Baran Mollavelıoglu ◽  
Kaan Ali Fuat Gok ◽  
Mehmet Ilhan ◽  
Cemalettın Ertekın

Abstract Introduction Morel Lavallée lesion is a hemolymphatic collection in between muscular fascia that can be caused by the separation of soft tissue and muscular fascia in degloving fashion. Morel Lavallée lesion is an infrequent lesion but should be known for medico-legal reports Morel Lavallée is a rare presentation that can cause life-threatening septic and hemorrhagic shock. Case PresentationIn this case report we are going present Morel Lavallée lesion which can present with septic shock and bleeding and can be mortal. Our patient, fourty seven years old male, arrived at the emergency department with an ambulance 1 hour after an extravehicular traffic accident. Apart from a right hemopneumothorax with multiple rib fractures, grade 2 laceration in spleen and bilateral kidneys, zone 2 fracture of sacrum, computer tomography (CT) revealed a closed, degloving injury of the pelvis , also known as a Morel-Lavallée lesion. On CT, Morel Lavallée lesion appear as well-defined, encapsulated fluid collections that occasionally show fluid fluid levels .. Heavy fluid collection was detected in control CT which was actually a collection infected hematoma in the operative setting. Patient was diagnosed in the first 12 hours and necrotic tissues were debrided. Patient was considered deceased after 15 days without any improvement in his GCS score.ConclusionsThere is one report that describe mortality after Morel Lavallée lesion in the autopsy setting. Early diagnosis and treatment are essential to decrease severity of necrosis and sepsis though our patient has deceased due to complications of sepsis


2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Çağla Yazar ◽  
Fatma İrem Yeşiler ◽  
Helin Şahintürk ◽  
Coşkun Araz ◽  
Pınar Zeyneloğlu

2021 ◽  
Vol 49 (5) ◽  
pp. 417-419
Author(s):  
Basak Altıparmak ◽  
◽  
Melike Korkmaz Toker ◽  
Ali Ihsan Uysal ◽  
Semra Gümüs Demirbilek ◽  
...  

2021 ◽  
Author(s):  
Bing Zhang ◽  
GongKe Li ◽  
YuRong Wang ◽  
yong li

Abstract Objective To explore the factors affecting the timing and prognosis of early tracheostomy(within 7 days after tracheal intubation) in patients with multiple rib fractures. Methods A retrospective analysis of the medical history of 222 patients with multiple rib fractures who were admitted to the department of emergency intensive care unit(EICU) of the affiliated hospital of Yangzhou University from February 2015 to October 2019 underwent early tracheostomy. According to the time from tracheal intubation to tracheostomy after admission, the patients were divided into two groups: early tracheostomy group (within 7 days after tracheal intubation,ET) and late tracheostomy group (after the 7th day, LT). The propensity score matching analysis technique was used to compare the differences between the two groups in a 1:1 ratio. Results A total of 222 patients were enrolled, with 118 in the ET group and 104 in the LT group. After matching, 87 in the ET group and 87 in the LT group. The proportion of acute respiratory distress syndrome(ARDS)[59(67.8%)], the volume of pulmonary contusion (VPC)[33.8±11.4], and number of total rib fractures (NTRF)[10.8±2.7] in the ET were significantly higher than those in the LT group, P<0.05. Binary Logistic regression analysis showed that ARDS[OR=3.740, 95%CI(1.441, 9.711)], VPC[OR=1.087, 95%CI(1.052, 1.124)], and NTRF [OR=1.775, 95%CI(1.439, 2.188)] were independent risk factors for ET.The Pearson analysis showed that VPC and NTRF had significant correlation(R=0.369, P=0.01), ARDS and VPC had low degree correlation(R=0.179, P=0.018), while ARDS and NTRF had no significant correlation(R=0.132, P=0.110). Receiver operating characteristic(ROC)curve analysis showed that the area under VPC and NTRF curves [0.832(95%CI: 0.770~0.893),0.804(95%CI: 0.740~0.868)] were significantly more than the number of rib fractures(NFR), glasgow coma scale(GCS), and injury severity score(ISS), P<0.05. COX regression analysis showed that patients with underwent ET survived significantly better than the LT, P<0.05. Conclusions We found that ARDS, VPC, and NTFR were independent risk factors for ET; VPC ≥ 23.9% and (or) NTRF ≥ 8.5 could be used as predictors of ET in patients with multiple rib fractures. There was a linear relationship between NTRF and VPC. ET might benefit patients with multiple rib fractures.


2021 ◽  
Vol 11 (11) ◽  
pp. 1067
Author(s):  
Chien-An Liao ◽  
Tai-Horng Young ◽  
Chi-Tung Cheng ◽  
Ling-Wei Kuo ◽  
Chih-Yuan Fu ◽  
...  

Background: Multiple rib fractures is a common chest trauma with a significant and sustained impact on pulmonary function and quality of life. Continuous monitoring of the pulmonary function parameter was necessary to adjust the therapeutic goals in these patients. We developed an internet-based remote system for lung function monitoring with a remote spirometry and smart device application to follow up these patients consecutively. Method: From Jan 2021 to April 2021, we conducted a prospective study that applied an intelligent spirometry system for patients with multiple rib fractures. With informed consent, we collected clinical data from them and introduced the remote spirometry system. We followed up with these patients for 12 weeks after trauma and compared the recovery of pulmonary function parameters and clinical outcomes. Result: A total of 21 patients were enrolled in our study. We divided them into two groups by the compliance to this remote spirometry system. The improvement of forced vital capacitywas better in the good compliance group than the poor compliance group (110% versus 21%, p value 0.049). Moreover, the complication rate was also lower in the good compliance group than the poor compliance group (10% versus 66.7% p value 0.017). Conclusion: Remote spirometry system is a novel system that can help in lung rehabilitation in patients with multiple rib fractures. Patients that cooperate well with this system presented superior lung function improvement and inferior complication rate.


Trauma ◽  
2021 ◽  
pp. 146040862110467
Author(s):  
Paramvir Singh ◽  
Ashish Sakharpe ◽  
Jasmeen Kaur ◽  
Anterpreet Dua ◽  
Shvetank Agarwal ◽  
...  

Blunt trauma patients commonly present with multiple rib fractures, which increases overall morbidity and mortality due to pulmonary complications. Effective chest wall analgesia may be challenging due to positioning difficulty, body habitus, anticoagulation issues with neuraxial interventions, etc. Serratus anterior plane block has been shown to be beneficial in anterior and lateral rib fractures in recent studies. We propose the efficacy of this block in posterior rib fractures as well, through this small case series of blunt trauma patients with posterior rib fractures, reporting significant pain relief after the block.


2021 ◽  
Author(s):  
Axel Benhamed ◽  
Amina Ndiaye ◽  
Marcel Emond ◽  
Thomas Lieutaud ◽  
Marion Douplat ◽  
...  

Abstract Thoracic trauma is the third most common cause of death in multi-trauma patients. One of the most frequent mechanism is road traffic accident (RTA). The objective of the present study was to investigate the influence of severe (abbreviated injury scale, AIS≥3) injuries in each body region on the mortality of multi-trauma patients with a particular attention to thoracic trauma. We also described the epidemiology and injury pattern of these patients when presenting with at least one AIS ≥2 thoracic injury (AISThorax≥2). Patients included in the Rhône RTA registry between 1997 and 2016, with at least one AIS ≥2 injury in any body region were included. Two subgroups were defined according to whether patients presented at least one AISThorax≥2 injury or not. Multivariate regression analysis with mortality as outcome was performed. A total of 46,526 patients had at least one AIS≥2 injury, among them 6,382 (13.7%) had at least one AISThorax≥2 injury. Severe thoracic injuries (OR=12.2, 95%CI [8.4;17.7]) were strongly associated with death, second to severe head injuries were (OR=26.8, 95%CI [20.4;35.2]). Chest wall injuries were the most frequent thoracic injury (62.1%, n=5,419) and 52.4% of these were multiple rib fractures. Severe thoracic injury is a priority in multi-trauma patients; both in the detection but also in the management.


2021 ◽  
pp. 021849232110422
Author(s):  
Koki Eto ◽  
Yosuke Miyamoto ◽  
Yukio Kioka ◽  
Mitsuhito Kuriyama

We report the case of a 39-year-old man who underwent surgical repair for traumatic Stanford type B acute aortic dissection. He was involved in a traffic accident, resulting in multiple rib fractures and a sternum fracture. On investigation, he was also found to have anatomical anomalies, namely, situs inversus and abnormality in the aortic arch and neck vessels. Thoracic endovascular aortic repair was performed as it is a less invasive procedure, thus recommended in such cases. A fenestrated thoracic endovascular aortic repair using the Najuta stent graft was found to be effective in this case where the anomalous anatomy was pre-existing.


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