SEARCH · Search PubMed
Results for “RIB FRACTURES”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
[Spontaneous rib fractures in silicosis].
Explore the source record for details and available documents.
[Treatment of rib fractures with a new anesthetic with prolonged action].
Explore the source record for details and available documents.
[Non-pathological spontaneous rib fracture during asthmatic attack].
Explore the source record for details and available documents.
[Treatment of multiple ribs fractures].
Of 267 patients with multiple fractures of the ribs, 69 patients had mobile costal valves. As a rule, the presence of the floatable chest wall site, is a cause of increasing respiratory failure ending in lethal outcome in 40 to 80% of cases. Indications for combined conservative therapy and its scope are specified and efficiency of different methods of restoration the chest wall frame is evaluated. The technique of pericostal ligature fixation of the mobile costal valves to the thorax splint offered by the authors was improved. The performance of this manipulation may be essentially easier thanks to the use of the device for passing ligature around the ribs and breast bone, which was developed by the authors and patented in Russian Federation. Clinical application of the developed technique allows rather quickly to control respiratory failure. The lethality tell 6 times in comparison with patients who were treated with the use of the other methods of the floatable costal valves fixation.
Differentiation of rib fractures from metastases by bone scanning.
The bone scans of 471 cancer patients revealed 103 (22%) with one or more rib lesions. Of 69 patients who had serial studies, five (7%) had proven rib fractures, 13 (19%) had probable fractures, 25 (36%) had proven metastases, and 26 (38%) had probable metastases. By analyzing the intensity and appearance of rib lesions in serial bone scans, it was concluded that there is a high probability that rib lesions detected by bone scanning are fractures if 1) they are focal as opposed to linear, and 2) they decrease in intensity within three to six months or they are aligned so as to involve two or more ribs in the same location.
Traumatic disruption of the manubriosternal joint in the absence of rib fractures.
A case of traumatic disruption of the manubriosternal joint in the absence of rib fractures has been seen. The manubrium was displaced posteriorly on the sternum. Treatment by observation only was followed by a satisfactory outcome with new bone being laid down to produce a false joint.
Rib fractures complicating median sternotomy.
The postoperative chest radiographs of 100 consecutive patients undergoing median sternotomy were reviewed for the presence of acute rib fractures. The majority of patients underwent coronary artery bypass grafting. Thirteen patients sustained 15 fractures. Eleven of these fractures were of the left first rib and 7 of the 15 fractures occurred at the costotransverse articulation. The fractures tended to be subtle on the postoperative portable chest radiographs and were initially overlooked in 4 patients. Heavier patients and those with larger body surface areas were more susceptible to the development of fractures. There was no statistical correlation to total operating time, bypass time, or global ischemic time.
Successful treatment of exsanguinating aortic injury from a fractured rib.
A 57-year-old man presented in shock after a 15-foot fall from a ladder. A massive left hemothorax was present. He underwent prompt thoracotomy and was found to have a penetrating injury of the descending thoracic aorta caused by a fractured rib. Successful management of this type of aortic injury has not been previously reported.
[Clinical evaluation of extramedullary osteosynthesis in multiple rib fractures in conjunction with severe mechanical trauma and accompanying shock].
Extramedullary osteosynthesis of ribs was performed in 18 patients with apparatus SPG-20 for multiple rib fractures. The early surgical treatment of patients with thoracic traumas resutled in a substantial improvement of the external respiration function, the volume of intrapulmonary shunt, alveolar-arterial oxygen gradient and respiratory index being considerably decreased. The use of a mechanical suture of the ribs as a component in the complex treatment of patients with a thoracic trauma is an efficient method in the struggle against posttraumatic respiratory insufficiency and shock.
The treatment of patients with multiple rib fractures using continuous thoracic epidural narcotic infusion.
The incidence of tracheostomy, length of intensive care unit (ICU) and total hospital stay, and duration of ventilatory support were evaluated prospectively in 28 patients who had multiple rib fractures. The patients were randomly divided into two groups: 13 patients were given standard morphine parenteral analgesia and constituted the control group (Group 1), and 15 patients had thoracic epidural catheter placement within 72 hours from the time of admission to the ICU (Group 2). Group 2 patients had less ventilator-dependent time compared with control patients (3.07 +/- 1.35 days vs. 18.23 +/- 8.12 days, p less than 0.05), less time in ICU (5.93 +/- 1.44 days vs. 18.69 +/- 5.25 days, p less than 0.02), and a shorter hospital stay (14.85 +/- 2.21 days vs. 47.69 +/- 14.67 days, p less than 0.03). Group 2 patients also had a lower incidence of tracheostomy versus control patients (6.7 +/- 6.7% vs. 38.5 +/- 14.0%, p less than 0.05). The authors believe that continuous thoracic epidural morphine analgesia may provide distinct pulmonary and economic advantages in patients with multiple rib fractures.
Treatment of multiple rib fractures. Randomized controlled trial comparing ventilatory with nonventilatory management.
We studied the treatment of multiple rib fractures in NIC, comparing ventilatory with nonventilatory methods in 69 patients who were randomly allocated to one of the following two treatments: (1) a CPAP mask combined with regional analgesia (n = 36); or (2) endotracheal intubation and mechanical ventilation with PEEP (n = 33). Clinical outcome was as follows: mean duration of treatment, 4.5 +/- 2.3 days for the group with CPAP and 7.3 +/- 3.7 days for the intubated group (p = 0.0003); mean number of days spent in intensive care, 5.3 +/- 2.9 days and 9.5 +/- 4.4 days, respectively (p = less than 0.0001); mean period of hospitalization, 8.4 +/- 7.1 days and 14.6 +/- 8.6 days, respectively (p = 0.0019); and patients developing complications: 28 percent (10/36) and 73 percent (24/33), respectively. Infections caused the difference in complications, primarily pneumonias, which occurred in 14 percent (5/36) of the group with CPAP but in 48 percent (16/33) of the intubated group. We conclude that treatment with a CPAP mask combined with regional analgesia can shorten and simplify treatment in these patients, mainly through a decreased infection rate, when compared with intubation and mechanical ventilation, and we recommend this treatment in patients similar to our sample.
Spontaneous radiation-induced rib fractures in breast cancer patients treated with postmastectomy irradiation. A clinical radiobiological analysis of the influence of fraction size and dose-response relationships on late bone damage.
The influence of fraction size on normal tissue damage was analysed in 231 patients treated with postmastectomy irradiation given either with a 12-fraction regimen (1978-1980) or with a 22-fraction regimen (1981). Chest radiographs taken 1-6 years after treatment were reviewed for spontaneous, radiation-induced rib fracture within the treated area. Patients treated with a large dose per fraction had significantly higher incidence of late bone damage (19%) than patients treated with a standard dose per fraction (6%) even though they had been treated with the aim to obtain equivalent biologic response according to the NSD formula. Furthermore, there was a clear dose-response relationship, especially in the 12-fraction regimen, where the total dose at the reference point varied over a wide range. Isoeffect doses could be estimated for the two different fractionation schedules. Using the linear quadratic model, alpha/beta ratios for late bone damage were estimated to be within the range of 1.8-2.8 Gy, i.e. similar to those reported for other late responding normal tissues.
[Thoracic epidural analgesic (TEA) or controlled ventilation in the treatment of patients with multiple rib fractures (author's transl)].
In the last seven years 283 trauma patients were treated for multiple rib fractures and/or flail chest. Primary management consisted of only morphine analgesia in 16 patients, TEA in 112 patients, and mechanical ventilation in 155 patients. The indication for mechanical ventilation was always associated injuries (cerebral contusion, para- and tetraplegia, aspiration, severe lung contusion) and not the instability of the thoracic cage.
[Surgical stabilization of multiple rib fracture and flail chest].
The experience of 14 cases with surgical stabilization of multiple rib fracture and flail chest was reported. They were 11 men and 3 women of 31 to 87 years of age. Paradoxical chest movement was noted in 10 patients. Thirteen of 14 patients successfully weaned from the ventilator less than 7 days after surgery. Of 14, 4 cases were treated with internal fixation and the others were with acetabular reconstruction plates with or without rib stapler. No case of death was experienced. Ten patients who were performed fixation with acetabular reconstruction plate weaned from the ventilator earlier than cases treated by internal fixation, suggesting the superiority of the acetabular reconstruction plate. Improvement of rib stapler and the development of a titanium plate of specific use for rib is expected in the future.
Detection of subtle undisplaced rib fractures in a porcine model: radiation dose requirement--digital flat-panel versus screen-film and storage-phosphor systems.
PURPOSE: To compare a large-area direct read-out flat-panel detector radiography system with screen-film and storage-phosphor systems with regard to detection of subtle undisplaced rib fractures and to assess the diagnostic performance of the flat-panel system with decreasing exposure level. MATERIALS AND METHODS: Subtle fractures were created artificially in 100 of 200 porcine rib specimens. Specimens were enclosed in containers of water to generate absorption and scatter radiation conditions similar to those of a human chest wall. Imaging was performed with flat-panel, screen-film, and storage-phosphor systems with conditions that were exactly matched. Different exposure levels equivalent to speed classes (S) of 400, 800, 1,600, and 6,400 were used. All images were independently assessed for the presence of fracture by three radiologists with a five-level confidence scale. Receiver operating characteristic (ROC) analysis was performed for a total of 4,200 observations (600 for each imaging system and exposure level). Diagnostic performance was estimated with area under the ROC curve (Az). Significance of differences in diagnostic performance was tested with analysis of variance. RESULTS: ROC analysis yielded mean Az values for the flat-panel system of 0.879 (S = 400), 0.833 (S = 800), 0.765 (S = 1,600), and 0.576 (S = 6,400). Az values were 0.834 (S = 400) for the screen-film system and 0.789 (S = 400) and 0.729 (S = 800) for the storage-phosphor system. Analysis of variance revealed significant differences in diagnostic performance between various combinations of imaging system and exposure levels (P <.05). CONCLUSION: The flat-panel system is superior to the screen-film and storage-phosphor systems for detection of subtle undisplaced rib fractures at clinical exposure settings (eg, S = 400). With the flat-panel system, radiation dose can be reduced by 50% to achieve diagnostic performance comparable to that of a speed class 400 screen-film system.
[Modern treatment of closed rib fractures].
Explore the source record for details and available documents.
[On the treatment of rib fractures].
Explore the source record for details and available documents.