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Management is a mixture of medical (eg pain relief, respiratory support, chest drainage and antibiotics), non-medical (physiotherapy and rehabilitation) and surgical (fixation of rib fractures if appropriate and operative treatment of cardiac, lung, airway, diaphragm and oesophageal injuries).
When a bone fractures, the fragments lose their alignment in the form of displacement or angulation. For the fractured bone to heal without any deformity the bony fragments must be re-aligned to their normal anatomical position. Orthopedic surgery attempts to recreate the normal anatomy of the fractured bone by reduction of the displacement.
Early surgery is important, as diaphragmatic atrophy and adhesions occur over time. Sutures are used in the repair. [12] Other injuries, such as hemothorax, may present a more immediate threat and may need to be treated first if they accompany diaphragmatic rupture. [6] Video-assisted thoracoscopy may be used. [4]
unstable spinal fracture-dislocation at the thoracolumbar junction: Thoracic Spine Fractures and Dislocations at eMedicine: Hume fracture: A.C. Hume: olecranon fracture with anterior dislocation of radial head: Ronald McRae, Maxx Esser. Practical Fracture Treatment 5th edition, page 187. Elsevier Health Sciences, 2008.
Rib fractures usually occur from a direct blow to the chest such as during a motor vehicle collision or from a crush injury. [2] [1] Coughing or metastatic cancer may also result in a broken rib. [1] The middle ribs are most commonly fractured. [5] [1] Fractures of the first or second ribs are more likely to be associated with complications. [6]
Video-assisted thoracoscopic surgery (VATS) is a type of minimally invasive thoracic surgery performed using a small video camera mounted to a fiberoptic thoracoscope (either 5 mm or 10 mm caliber), with or without angulated visualization, which allows the surgeon to see inside the chest by viewing the video images relayed onto a television screen, and perform procedures using elongated ...
Flail chest typically occurs when three or more adjacent ribs are fractured in two or more places, allowing that segment of the thoracic wall to displace and move independently of the rest of the chest wall. Flail chest can also occur when ribs are fractured proximally in conjunction with disarticulation of costal cartilages distally. For the ...
Trauma surgery is a surgical specialty that utilizes both operative and non-operative management to treat traumatic injuries, typically in an acute setting. Trauma surgeons generally complete residency training in general surgery [ 1 ] [ 2 ] and often fellowship training in trauma or surgical critical care .