TY - CHAP M1 - Book, Section TI - Chest Wall Stabilization and Novel Closures of the Chest A1 - DaSilva, Marcelo C. A2 - Sugarbaker, David J. A2 - Bueno, Raphael A2 - Colson, Yolonda L. A2 - Jaklitsch, Michael T. A2 - Krasna, Mark J. A2 - Mentzer, Steven J. A2 - Williams, Marcia A2 - Adams, Ann Y1 - 2015 N1 - T2 - Adult Chest Surgery, 2e AB - Prior to the 1950s, the approach to treating skeletal trauma or deformity of the chest was largely nonoperative. Advances in anesthesia, cardiothoracic surgery, bioprosthetic materials, and mechanical ventilation in the second half of the 20th century reduced the morbidity and mortality of operating in the chest, creating a safer environment for surgical intervention. Potential indications for rib fracture repair include flail chest, non-united rib fractures refractory to conventional pain management, chest wall deformity or defect, and trauma-associated rib fracture and respiratory failure which may be repaired during thoracotomy for other traumatic injury. Several effective repair systems have been developed. These have made plating of ribs and stabilization of the chest wall safe, effective, and easy to perform. Future directions for progress on this important surgical problem include the development of minimally invasive techniques and the conduct of multicenter, randomized trials. In this chapter, we propose a unique classification for flail chest based on vector force applied to the chest wall and its underlying physiologic response to that force. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/19 UR - accesssurgery.mhmedical.com/content.aspx?aid=1105846224 ER -