Surgical Treatment of Flail Chest and Rib Fractures
| Autor: | Michael J. Bellino, Benjamin C. Taylor, Peter L. Althausen, T. Ty Fowler |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Thorax
medicine.medical_specialty Flail chest Rib Fractures business.industry Mortality rate medicine.medical_treatment Chronic pain medicine.disease Intensive care unit Surgery law.invention Pneumonia Thoracotomy law Flail Chest medicine Humans Orthopedic Procedures Orthopedics and Sports Medicine Respiratory function Intensive care medicine business |
| Zdroj: | Journal of the American Academy of Orthopaedic Surgeons. 22:751-760 |
| ISSN: | 1067-151X |
| DOI: | 10.5435/jaaos-22-12-751 |
| Popis: | Despite significant advances in critical care management, flail chest remains a clinically significant finding, with a mortality rate of up to 33%. Nonsurgical management is associated with prolonged ventilator support, pneumonia, respiratory difficulties, and lengthy stays in the intensive care unit, as well as chronic pain from nonunion and malunion of the bony thorax. Treatment with aggressive pulmonary toilet, ventilator support, and different modalities of pain control remains the benchmark of care. However, several recent randomized controlled studies of surgical intervention of flail chest have demonstrated an improvement in the number of ventilator days, intensive care unit and hospital stays, incidence of pneumonia, and respiratory function and hospital costs, as well as faster return to work. The success of these surgical constructs compared with those of historical attempts at open fixation is largely the result of modern plating technology and improvement in surgical approaches. Clinical evidence continues to grow regarding proper indications and techniques for surgical stabilization of flail chest. |
| Databáze: | OpenAIRE |
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