Citation

Bailey J, Vanderheiden T, Burlew CC, Pinski-Sibbel S, Jordan J, Moore EE, Stahel PF. World J. Emerg. Surg. 2012; 7(1): 14.

Copyright

(Copyright © 2012, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/1749-7922-7-14

PMID

22587588

Abstract

BACKGROUND: Severe chest wall injuries are potentially life-threatening injuries which require a standardized multidisciplinary management strategy for prevention of posttraumatic complications and adverse outcome. CASE PRESENTATION: We report the successful management of a 55-year old man who sustained a complete "bony disruption" of the thoracic cage secondary to an "all-terrain vehicle" roll-over accident. The injury pattern consisted of a bilateral "flail chest" with serial segmental rib fractures, bilateral hemo-pneumothoraces and pulmonary contusions, bilateral midshaft clavicle fractures, a displaced transverse sternum fracture with significant diastasis, and an unstable T9 hyperextension injury. After initial life-saving procedures, the chest wall injuries were sequentially stabilized by surgical fixation of bilateral clavicle fractures, locked plating of the displaced sternal fracture, and a two-level anterior spine fixation of the T9 hyperextension injury. The patient had an excellent radiological and physiological outcome at 6 months post injury. CONCLUSION: Severe chest wall trauma with a complete "bony disruption" of the thoracic cage represents a rare, but detrimental injury pattern. Multidisciplinary management with a staged timing for addressing each of the critical injuries, represents the ideal approach for an excellent longterm outcome.

Language: en