Contemporary management of flail chest

American Surgeon

Volumn 80, Issue 6, 2014, Pages 527-535

  Vana, P Geoff ^a   Neubauer, Daniel C ^b   Luchette, Fred A ^a,b  

^a Department of Surgery ^*  (United States)

^b LOYOLA UNIVERSITY CHICAGO   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ANALGESIC AGENT;

ARTIFICIAL VENTILATION; BLUNT TRAUMA; BONE PLATE; CLINICAL FEATURE; COMPUTER ASSISTED TOMOGRAPHY; EPIDURAL ANESTHESIA; FLAIL CHEST; FLUID RESUSCITATION; HUDSON METHOD; HUMAN; INTERNAL FIXATOR; INTRAMEDULLARY NAIL; LENGTH OF STAY; LUNG CONTUSION; LUNG FUNCTION TEST; LUNG LAVAGE; MORBIDITY; MORTALITY; PATHOPHYSIOLOGY; PATIENT POSITIONING; PHYSICAL EXAMINATION; REGIONAL ANESTHESIA; REVIEW; RIB FRACTURE; SURGICAL TECHNIQUE; THORACOTOMY; THORAX PAIN; THORAX RADIOGRAPHY; TREATMENT INDICATION; DISEASE MANAGEMENT; INJURY SCALE; METHODOLOGY; OSTEOSYNTHESIS;

DISEASE MANAGEMENT; FLAIL CHEST; FRACTURE FIXATION, INTERNAL; HUMANS; INJURY SEVERITY SCORE; RIB FRACTURES; TOMOGRAPHY, X-RAY COMPUTED;

EID: 84904876776     PISSN: 00031348     EISSN: 15559823     Source Type: Journal    
DOI: None     Document Type: Review

References (87)

1. Jones TB, Richardson EP. Traction on the sternum in the treatment of the multiple fractured ribs. Surg Gynecol Obstet 1926;42:283-5.
2. Cameron J. Current Surgical Therapy. 8th ed. St. Louis, MO: Mosby; 2004.
3. Ziegler DW, Agarwal NN. The morbidity and mortality of rib fractures. J Trauma and Acute Care Surg 1994;37:975-9.
4. Sirnali M, Turut H, Tpocu S, et al. A comprehensive analysis of traumatic rib fractures: morbidity, mortality and management. Eur J Cardiothorac Surg 2003;24:133-8.
5. Bastos R, Calhoon JH, Baisden CE. Flail chest and pulmonary contusion. Semin Thorac Cardiovasc Surg 2008;20:39-45.
6. Flagel B, Luchette FA, Reed RL, et al. Half a dozen ribs: the breakpoint for mortality. Surgery 2005;138:717-25.
7. Jones KM, Reed RL II, Luchette FA. The ribs or not the ribs: which influences mortality. Am J Surg 2011;202:598-604.
8. Champion HR, Copes WS, Sacco WJ. The major trauma outcome study. J Trauma 1990;30:1356-65.
9. Hagen K. Multiple rib fractures treated with a Drinker respirator: a case report. JBJS Case Connect 1945;27:330-4.
10. Clark G, Schecter W, Trunkey D. Variables affecting outcome in blunt chest trauma: flail chest vs. pulmonary contusion. J Trauma 1988;28:298-304.
11. Todd SR, McNally MM, Holcomb JB, et al. A multidisciplinary clinical pathway decreases rib fracture-associated infectious morbidity and mortality in high-risk trauma patients. Am J Surg 2006;192:806-11.
12. Miller PR, Croce MA, Bee TK, et al. ARDS after pulmonary contusion: accurate measurement of contusion volume identifies high-risk patients. J Trauma 2001;51:223-30.
13. Kleinman PK, Schlesinger AE. Mechanical factors associated with posterior rib fractures: laboratory and case studies. Pediatr Radiol 1997;27:87-91.
14. Wanek S, Mayberry J. Blunt thoracic trauma: flail chest, pulmonary contusion, and blast injury. Crit Care Clin 2004;20:71-81.
15. Viano D, Lau I, Asbury C. Biomechanics of the human chest, abdomen, and pelvis in lateral impact. Accid Anal Prev 1989;21:553-74.
16. McGwin G, Melton SM, May AK, et al. Long-term survival in the elderly after trauma. J Trauma 2000;49:470-6.
17. Richardson JD, Adams L, Flint LM. Selective management of flail chest and pulmonary contusion. Ann Surg 1982;196:481-7.
18. Craven KD, Openheimer L, Wood LDH. Effects of contusion and flail chest on pulmonary perfusion and oxygen exchange. J Appl Physiol 1976;47:729-37.
19. Freedland M, Wilson RF, Bender JS, et al. The management of flail chest injury: factors affecting outcome. J Trauma 1990;30:1460-8.
20. Davis KA, Fabian TC, Croce MA, et al. Prostanoids: early mediators in the secondary injury that develops after unilateral pulmonary contusion. J Trauma 1999;46:824-31.
21. Tanaka H, Yukioka T, Yamaguti Y, et al. Surgical stabilization or internal pneumatic stabilization? A prospective randomized study of management of severe flail chest patients. J Trauma 2002;52:727-32.
22. Ker-Valentic MA, Arthur M, Mullins RJ, et al. Rib fracture pain and disability: can we do better? J Trauma 2003;54:1058-63.
23. Lafferty PM, Anavian J, Will RE, et al. Operative treatment of chest wall injuries: indications, technique, and outcomes. J Bone Joint Surg Am 2011;93:97-110.
24. Trinkle JK, Richardson JD, Franz JL. Management of flail chest without mechanical ventilation. Ann Thorac Surg 1975;19:355-63.
25. LaBan MM, Siegel CB, Schut LK, et al. Occult radiographic fractures of the chest wall identified by nuclear scan imaging: report of seven cases. Arch Phys Med Rehabil 1994;75:353-4.
26. Livingston D, Shogan B, Jhn P, et al. CT diagnosis of rib fractures and the prediction of acute respiratory failure. J Trauma 2007;64:905-11.
27. Omert L, Yeaney WW, Protetch J. Efficacy of thoracic computerized tomography in blunt chest trauma. Am Surg 2001;67:660-4.
28. Clark CG, Schecter WP, Trunkey DD. Variables affecting outcome in blunt chest trauma: flail chest vs. pulmonary contusion. J Trauma 1988;28:298-304.
29. Heroy WW, Eggleston FC. A method of skeletal traction applied through the sternum in steering wheel injuries of the chest. Ann Surg 1951;133:135-8.
30. Bollinger CT, Van Eeden ST. Treatment of multiple rib fractures: randomized controlled trial comparing ventilatory with nonventilatory management. Chest 1990;98:943-8.
31. Avery EE, Benson DW, Morch ET. Critically crushed chests. J Thorac Surg 1956;32:291-311.
32. Shackford SR, Smith DE, Zarins CK, et al. The management of flail chest: a comparison of ventilatory and nonventilatory treatment. Am J Surg 1976;132:759-62.
33. Webb WR. Thoracic trauma. Surg Clin North Am 1974;54:1179-92.
34. Maloney JV, Schmutzer KJ, Raschke E. Paradoxical respiration and Pendelluft. J Thorac Cardiovasc Surg 1961;41:291-8.
35. Carpintero JL, Rodriguez-Diez A, Ruiz Elvira MJ, et al. Methods of management of flail chest. Intensive Care Med 1980;6:217-21.
36. Mackersie RC, Shackford SR, Hoyt DB, et al. Continuous epidural fentanyl analgesia: ventilatory function improvement with routine use in treatment of blunt chest injury. J Trauma 1987;27:1201-12.
37. Luchette FA, Radafshar SM, Kaiser R, et al. Prospective evaluation of epidural versus intrapleural catheters for analgesia in chest wall trauma. J Trauma 1994;36:865-70.
38. Moon MR, Luchette FA, Gibson SW, et al. Prospective, randomized comparison of epidural versus parenteral opioids analgesia in thoracic trauma. Ann Surg 1998;229:684-92.
39. Pressley CM, Fry WR, Philp AS, et al. Predicting outcome of patients with chest wall injury. Am J Surg 2012;204:910-4.
40. Cullen P, Modell JH, Kirby RR, et al. Treatment of flail chest. Arch Surg 1975;110:1099-103.
41. Ahmed Z, Mohyuddin Z. Management of flail chest: internal fixation versus endotracheal intubation and ventilation. J Thorac Cardiovasc Surg 1995;110:1676-80.
42. Mayberry JC, Terhes JT, Ellis TJ, et al. Absorbable plates for rib fracture repair: preliminary experience. J Trauma 2003;55:835-9.
43. Sing RF, Mostafa G, Matthews BD, et al. Thoracoscopic resection of painful rib fractures: case report. J Trauma 2002;52:391-2.
44. Engel C, Krieg JC, Madey SM, et al. Operative chest wall fixation with osteosynthesis plates. J Trauma 2005;58:181-6.
45. Kroell C, Schneider D, Nabum A. Impact tolerance and response of the human thorax. Stapp Car Crash J 1974;18:383-457.
46. Velmahos GC, Vassiliu P, Chan LS, et al. Influence of flail chest on outcome among patients with severe thoracic cage trauma. Int Surg 2002;87:240-4.
47. Richardson JD, Franklin GA, Heffly S, et al. Operative fixation of chest wall fractures: an underused procedure? Am Surg 2007;73:591-7.
48. Obertacke U, Neudeck F, Majetschak M, et al. Local and systemic reactions after lung contusion: an experimental study in the pig. Shock 1998;10:7-12.
49. Moore BP. Operative stabilization in nonpenetrating chest injuries. J Thorac Cardiovasc Surg 1975;70:619-30.
50. Paris F, Tarazona V, Blasco E, et al. Surgical stabilization of traumatic flail chest. Thorax 1975;30:521-7.
51. Thomas AN, Blaisdell FW, Lewis FR, et al. Operative stabilization for flail chest after blunt trauma. J Thorac Cardiovasc Surg 1978;75:793-801.
52. Di Fabio D, Benetti D, Benvenuti M, et al. Surgical stabilization of post-traumatic flail chest. Our experience with 116 cases treated. Minerva Chir 1995;50:227-33.
53. Beltrami V, Martinelli G, Giansante P, et al. An original technique for surgical stabilization of traumatic flail chest. Thorax 1978;33:528-9.
54. Sherman JE, Salzberg A, Raskin NM, et al. Chest wall stabilization using plate fixation. Ann Thorac Surg 1988;46:467-9.
55. Kishikawa M, Yoshioka T, Shimazu T, et al. Pulmonary contusion causes long-term respiratory dysfunction with decreased functional residual capacity. J Trauma 1991;31:1203-10.
56. Menard A, Testart J, Philippe JM, et al. Treatment of flail chest with Judet's struts. J Thorac Cardiovasc Surg 1983;86:300-5.
57. Landreneau RJ, Hinson JM Jr, Hazelrigg SR, et al. Strut fixation of an extensive flail chest. Ann Thorac Surg 1991;51:473-5.
58. Sales JR, Ellis TJ, Gillard J, et al. Biomechanical testing of a novel, minimally invasive rib fracture plating system. J Trauma 2008;64:1270-4.
59. Mouton W, Lardinois D, Furrer M, et al. Long-term follow-up of patients with operative stabilization of a flail chest. Thorac Cardiovasc Surg 1997;45:242-4.
60. Voggenreiter G, Neudeck F, Aufmkolk M, et al. Operative chest wall stabilization in flail chest - outcomes of patient with or without pulmonary contusion. J Am Coll Surg 1998;187:130-8.
61. Hellberg K, de Vivie ER, Fuchs K, et al. Stabilization of flail chest by compression osteosynthesis - Experimental and clinical results. J Thorac Cardiovasc Surg 1981;29:275-81.
62. Iwasaki A, Hamatake D, Shirakusa T. Biosorbable poly-L-lactide rib-connecting pins may reduce acute pain after thoracotomy. Thorac Cardiovasc Surg 2004;52:49-53.
63. Matsui T, Kitano M, Nakamura T, et al. Bioabsorbable struts made of poly-L-lactide and their application for treatment of chest deformity. J Thorac Cardiovasc Surg 1994;108:162-8.
64. Puma F, Ragusa M, Santoprete S, et al. As originally published in 1992: chest wall stabilization with synthetic reabsorbable material. Updated in 1999. Ann Thorac Surg 1999;67:1823-4.
65. Tatsumi A, Kanemitsu N, Nakamura T, et al. Bioabsorbable poly-L-lactide costal coaptation pins and their clinical application in thoracotomy. Ann Thorac Surg 1999;67:765-8.
66. Vijanen J, Pihlajamäki H, Kinnunen J, et al. Comparison of absorbable poly-L-lactide and metallic intramedullary rods in the fixation of femoral shaft osteotomies: an experimental study in rabbits. J Orthop Sci 2001;6:160-6.
67. Haasler GB. Open fixation of flail chest after blunt trauma. Ann Thorac Surg 1990;49:993-5.
68. Vu KC, Skourtis ME, Gong X, et al. Reduction of rib fractures with a bioresorbable plating system: preliminary observations. J Trauma 2008;64:1264-9.
69. Simon B, Ebert J, Bokhari F, et al. Management of pulmonary contusion and flail chest: an Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg. 2012;73(suppl 4):S351-61.
70. Bellezzo F, Hunt RJ, Provost R, et al. Surgical repair of rib fractures in 14 neonatal foals: case selection, surgical technique and results. Equine Vet J 2004;36:557-62.
71. Judet R. Osteosynthase costal. Rev Chir Orthop Repar Appar Mot 1973;59(suppl 1):334-5.
72. Livingston DH, Richardson JD. Pulmonary disability after severe blunt chest trauma. J Trauma 1990;30:562-7.
73. Lardinois D, Krueger T, Dusmet M, et al. Pulmonary function testing after operative stabilization of the chest wall for flail chest. Eur J Cardiothorac Surg 2001;20:496-501.
74. Solberg BD, Moon CN, Nissim AA, et al. Treatment of chest wall implosion injuries without thoracotomy: technique and clinical outcomes. J Trauma 2009;67:8-13.
75. Granetzny A, Abd El-Aal M, Emam E, et al. Surgical versus conservative treatment of flail chest. Evaluation of the pulmonary status. Interact Cardiovasc Thorac Surg 2005;4:583-7.
76. Marasco SF, Abd El-Aal M, Emam E, et al. Prospective randomized controlled trial of operative rib fixation in traumatic flail chest. J Am Coll Surg 2012;216:924-32.
77. Cacchione RN, Richardson JD, Seligson D. Painful non-union of multiple rib fractures managed by operative stabilization. J Trauma 2000;48:319-21.
78. Oyarzun JR, Bush AP, McCormick JR, et al. Use of 3.5-mm acetabular reconstruction plates for internal fixation of flail chest injuries. Ann Thorac Surg 1998;65:1471-4.
79. Ng AB, Giannoudis PV, Bismil Q, et al. Operative stabilization of painful non-united multiple rib fractures. Injury 2001;32:637-9.
80. Mayberry J, Trunkey D. The fractured rib in chest wall trauma. Chest Surg Clin N Am 1997;7:239-61.
81. Balci AE, Eren S, Cakir O, et al. Open fixation in flail chest: review of 64 patients. Asian Cardiovasc Thorac Ann 2004;12:11-5.
82. Beal SL, Oreskovich MR. Long-term disability associated with flail chest injury. Am J Surg 1985;150:324-6.
83. Wilson JM, Thomas AN, Goodman PC, et al. Severe chest trauma. Morbidity implication. Arch Surg 1978;113:846-9.
84. Ferguson M, Luchette FA. Management of blunt chest injury. Respir Care Clin N Am 1996;2:449-66.
85. Borrelly J, Aazami MH. New insights into the pathophysiology of flail segment: the implications of anterior serratus muscle in parietal failure. Eur J Cardiothorac Surg 2005;28:742-9.
86. Teng JP, Cheng Y-G, Ni D, et al. Outcomes of traumatic flail chest treated by operative fixation versus conservative approach. J Shanghai Jiaotong University 2009;29:1495-8 (Medical Science).
87. Fitzgerald DC, Denard PJ, Phelan D, et al. Operative stabilization of flail chest injuries: review of literature and fixation options. Eur J Trauma Emerg Surg 2010;36:427-33.