RT Book, Section
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
SR Print(0)
ID 1105846224
T1 Chest Wall Stabilization and Novel Closures of the Chest
T2 Adult Chest Surgery, 2e
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-178189-3
LK accesssurgery.mhmedical.com/content.aspx?aid=1105846224
RD 2024/04/24
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.