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Results for “RIB FRACTURES”

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PubMed2005

Extrapleural hematoma: when is surgery indicated?

Extrapleural haematoma (EH) is a rare clinical condition of which four cases are presented. Different etiologies were encountered. Identical findings were found on the chest X-ray. Two cases were secondary to spontaneous rib fracture and the other two were iatrogenic. Surgical exploration was necessary in one patient following pleural biopsy. Medical treatment and clinical observation were the treatment of choice in the remaining three stable patients.

Adult↗
PubMed1981

[Management of blunt chest trauma (author's transl)].

The diagnosis of life threatening situations due to blunt chest trauma, the priority of treatment, and therapeutical consequences are discussed. Rib fractures, pulmonary contusions could be treated conservatively. Tension pneumothorax and haemothorax need immediate decompression by intercostal tube drainage. The necessity for prompt exploratory surgery should always be considered in patients with massive haemothorax, tracheobronchial disruption and traumatic rupture of the diaphragm. Rupture or perforation of the oesophagus, traumatic aneurysms of the thoracic aorta, large diaphragmatic herniations, and penetrating thoraco-abdominal wounds demand an early thoracotomy. Indications for late thoracotomy are: clotted haemothorax and diaphragmatic herniations primarily not diagnosed.

Aortic Rupture↗
PubMedDate not supplied

Effective pain relief with intrapleural analgesia.

The use of an intrapleural catheter for pain relief following cholecystectomy, renal surgery or unilateral breast surgery was first described in 1984 by Kvalheim and Reiestad. Despite seemingly positive reviews (Tartiere et al, 1991), the use of this technique for managing acute pain is still not commonplace even though it has been described as a superior method of analgesia (Gibson, 1994). This article describes the successful use of intrapleural analgesia under two different circumstances: first, postoperatively following open cholecystectomy and, second, following an accident in which the patient sustained several unilateral rib fractures.

Analgesia↗
PubMed2005

Trauma and the paediatric lung.

Thoracic injury is a serious cause of morbidity and mortality in paediatric patients. This review will present cases to assist the clinician in the epidemiology, assessment and management of airway injury, pulmonary contusion, rib fracture, musculoskeletal injury and pneumothorax.

Child↗
PubMedDate not supplied

Rib-cage injuries indicating the direction and strength of impact.

The hardness and loading capacity of hundreds of rib pairs have been tested and compared with the results of about 200 tests concerning belt-protected human cadavers. Rib fractures exhibit patterns that indicate the direction and strength of impact. Differences are seen between static and dynamic loading. Deformation of the loaded rib cage can be demonstrated by X-ray examination.

Accidents, Traffic↗
PubMed2000

Thromboprophylaxis using a low molecular weight heparin delays fracture repair.

Low molecular weight heparins are significantly superior to unfractionated heparin or warfarin in the prevention of thromboembolic episodes associated with orthopaedic surgery. Therapeutic doses of heparin and warfarin have been shown to delay bone repair in a rabbit model. The current study investigated the effect of prophylactic administration of a low molecular weight heparin, enoxaparin, on the healing of a closed rabbit rib fracture. Fracture healing was assessed using histomorphometric, histologic, and immunohistochemical methods at 3, 7, and 14 days, and biomechanical testing with torsional loading was assessed after 21 days. Bone repair was significantly attenuated at all times in animals receiving subcutaneous enoxaparin compared with that of the control animals. Numerous putative mechanisms for this phenomenon are discussed, and additional studies are proposed to elucidate the effects of this pharmacologically diverse group of compounds on all aspects of bone physiology and repair.

Animals↗
PubMed1988

Sternal fractures--the natural history.

A five-year retrospective study was undertaken to analyze the natural history of sternal fractures and to scrutinize the current method of management. Sixty-six patients with documented sternal fractures were evaluated. The most common mechanism of injury was motor vehicle accidents (59%). Most of these victims did not wear seat belts. Thirty-five patients (53%) had associated injuries, of which rib fractures were the most common. Thirty-one patients (47%) had sternal fractures with no associated injury. The incidence of myocardial contusion in our study was 18%. Of the patients without associated injuries, the incidence of myocardial contusion was 6%. There were no mortalities in our study population, and there was no significant morbidity necessitating mechanical or pharmacologic support. The majority of these patients were managed by admission, observation, IV therapy, and placement of monitored beds. Our findings of no life-threatening sequelae suggest that we might question the necessity of current management criteria. This proves to be of special interest in view of the economic restraints imposed on health care today.

Accidents, Traffic↗
PubMed2002

Exsanguination due to right ventricular rupture during closed-chest cardiopulmonary resuscitation.

We report on a 61-year-old woman in whom cardiopulmonary resuscitation (CPR) was unsuccessful. While the patient was initially resuscitated from the primary cardiac arrest, with evidence of neurologic recovery, she ultimately succumbed to injuries resulting directly from closed-chest CPR. Autopsy revealed multiple rib fractures, a sternal fracture, pulmonary laceration, and cardiac rupture. In a patient with deteriorating vital signs following successful closed-chest CPR, such injuries should be considered.

Cardiopulmonary Resuscitation↗
PubMed1978

Flail chest syndrome and pulmonary contusion.

Controlled mechanical ventilation has been the mainstay of treatment in the flail chest syndrome for more than 20 years, retrospective studies have recently suggested that the technique is unnecessary, and they infer that spontaneous ventilation or intermittent mandatory ventilation are equally effective. The common theme of these investigations is that mechanical ventilation is required only to relieve hypoxemia associated with the underlying contusion. In two cases of flail chest, spontaneous respiratory efforts resulted in complete disruption of the fracture sites and thus prolonged the duration of mechanical ventilation that was required. In severe cases of flail chest syndrome, there is still a need for controlled mechanical ventilation to splint the rib fractures in a position which facilitates union of the fragments.

Adult↗