Injuries to the Chest Wall: Diagnosis and Management by Michael D. McKee, Emil H. Schemitsch

By Michael D. McKee, Emil H. Schemitsch

Up-to-date and multidisciplinary, this article brings jointly all the most up-to-date study and medical remedy concepts for the administration of accidents to the chest wall and rib cage. The administration of trauma to the chest wall, particularly “flail chest” accidents, has been fairly stagnant for a few years. Non-operative therapy has been the traditional of care, and regardless of a few advances, has reached the purpose the place there's little new to supply a seriously traumatized sufferer. despite the fact that, lately, there was a dramatic bring up within the curiosity in surgical fixation of risky chest wall accidents. particularly, plate or intramedullary nail fixation of a number of rib fractures has speedily develop into the cutting-edge in lots of trauma facilities, and there have a number of study papers, experiences, new fixation units, and tutorial classes at nationwide point conferences in this subject. This ebook assembles a various crew of specialists within the field—orthopedic surgeons, trauma surgeons, anesthetists, uncomplicated technology researchers—to produce the definitive paintings in this subject that may entice a large choice of scientific practitioners.

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Trinkle JK, Richardson JD, Franz JL, Grover FL, Arom KV, Holmstrom FM. Management of flail chest without mechanical ventilation. Ann Thorac Surg. 1975;19:355– 63. 1016/S0003-4975(10)64034-9. Shackford SR, Smith DE, Zarins CK, Rice CL, Virgilio RW. The management of flail chest. A comparison of ventilatory and nonventilatory treatment. Am J Surg. 1976;132:759–62. Nirula R, Diaz Jr JJ, Trunkey DD, Mayberry JC. Rib fracture repair: indications, technical issues, and future directions. World J Surg.

Management of isolated sternal fractures: determining the risk of blunt cardiac injury. Ann R Coll Surg Engl. 2000;82: 162–6. 23. Berg EE. The sternal-rib complex. A possible fourth column in thoracic spine fractures. Spine (Phila Pa 1976). 1993;18:1916–9. 24. Denis F. The three column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine (Phila Pa 1976). 1983;8: 817–31. 25. Pal JM, Mulder DS, Brown RA, Fleiszer DM. Assessing multiple trauma: is the cervical spine enough?

Major vascular tear Potential threats (not immediate) 1. Pulmonary and myocardial contusion 2. Vascular disruption 3. Flail chest 4. Diaphragmatic and esophageal rupture 3 The Pathophysiology of Flail Chest Injury 27 without suffering obvious external trauma [27]. Paradoxical motion of the chest wall was also considered to be the main cause of respiratory embarrassment in this subset of patients. This “pendelluft” or out-of-phase movement of the chest wall refers to the to-and-fro movement of deoxygenated air between the lung of the normal and flail side during spontaneous breathing and was considered to be the main cause of respiratory insufficiency.

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