Traumatic thoracic rib cage hernias: Operative management and proposal for a new anatomic-based grading system
| Autor: | Seth Izenberg, Elizabeth Windell, Jean-Stephane David, Matthew J. Martin, John Kuckelman, William B. Long, Riyad Karmy-Jones |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Rib Fractures Thoracic Injuries Tissue Flap Reconstruction Lung hernia Surgical Flaps 03 medical and health sciences 0302 clinical medicine Blunt Injury Severity Score Fracture Fixation medicine Humans Bone damage Range of Motion Articular Herniorrhaphy Retrospective Studies Rib cage Lung business.industry Surgical care Rib Cage 030208 emergency & critical care medicine General Medicine Perioperative Middle Aged Surgical Mesh Surgery medicine.anatomical_structure Treatment Outcome 030220 oncology & carcinogenesis Female Anatomic Landmarks business Bone Plates |
| Zdroj: | American journal of surgery. 215(5) |
| ISSN: | 1879-1883 |
| Popis: | Background Traumatic Rib Cage Hernias (TRCH) requiring operative repair are rare and there is currently no literature to guiding surgical management. Methods Perioperative review of TRCH over 32 years. Five operative grades were developed based on extent of tissue/bone damage, size, and location. Results Twenty-four patients (20 blunt, 4 penetrating) underwent operative repair. Lung was the herniated organ in 88% with a median of 4 rib fractures and average size of 60.25 cm. Types of operation were well clustered by assigned TRCH grade. The majority required mesh (75%) and/or rib plating (79%). Complex tissue flap reconstruction was required in 10%. Full range-of-motion was maintained in 88% with79% returning to pre-injury activity levels. Five patients had continued pain at final follow up (mean = 7months). Conclusion The size and degree of injury has important implications in the optimal surgical management of TRCHs. These operative grades effectively direct surgical care for these rare and complex injuries. |
| Databáze: | OpenAIRE |
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