Year: 2015
Type: article
Study design: Case Report
Abstract: Despite favourable outcome data [1], surgical stabilisation of severe rib fractures (SSRF) is employed in only the minority of cases of chest wall injuries [2].One barrier to widespread adoption of this procedure is concern about the operative morbidity [3].We recently reported our technique for open SSRF, which employs minimal incisions and muscle splitting whenever possible [4].However, this technique (and any open technique) remains limited by 1) the need for longer skin incisions; 2) the need for partial division of the lattisimus dorsi and trapezius muscles at the extremes of exposure in some fracture patterns; 3) the need for scapular retraction to gain exposure to subscapular fractures; 4) plate placement on the outer cortex of the ribs, which may be palpable by thinner patients; 5) risk of pulmonary or cardiac injury from drilling and screwing in an internal direction; and 6) the inability to routinely visualise the pleural space (unless a thoracotomy is performed).Herein we describe a case of totally thoracoscopic, intra-pleural SSRF, including fixation to the inner rib cortex, a technique which addresses each of the aforementioned limitations of the open approach. Case reportThe patient is a 63-year-old man who fell on a sheet of ice while intoxicated.Past medical history was significant for non-insulin-dependent diabetes mellitus, hypertension, and alcohol abuse.He was brought in by ambulance alert, oriented, and with normal vital signs.Imaging with CXR, followed by CT chest, revealed Trauma Case Reports 1 (2015) 39
Source: Trauma Case Reports
Institutions: Denver Health Medical Center, University of Colorado Anschutz
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,190
Funder: Salt Science Research Foundation
OpenAlex ID: W2189166602