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Review
. 2017 Apr;9(Suppl 3):S211-S217.
doi: 10.21037/jtd.2017.04.05.

Blunt chest trauma: is there a place for rib stabilization?

John D Mitchell  1
Affiliations
Review

Blunt chest trauma: is there a place for rib stabilization?

John D Mitchell. J Thorac Dis. 2017 Apr.

Abstract

Rib fractures are a common and highly morbid finding in patients with blunt chest trauma. Over the past decade, a renewed interest in (and instrumentation for) rib fixation in this cohort has occurred. Stabilization of the chest wall in this setting, particularly when a flail segment is present, is associated with significant reductions in the rates of respiratory failure, pneumonia, ICU stay, and mortality. Thoracic surgeons should remain actively involved in this evolving area of our specialty to further optimize patient outcomes.

Keywords: Blunt chest trauma; flail chest; rib fracture; rib stabilization.

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Conflict of interest statement

Conflicts of Interest: The author has no conflicts of interest to declare.

Figures

Figure 1
Figure 1
An example of a rib plating system (39). Note that the plates are contoured for specific ribs, including laterality. Courtesy of DuPuy Synthes (©DePuy Synthes 2017).
Figure 2
Figure 2
Application of rib plating system, with fixation using bicortical screws. Photo courtesy of Fredric M. Pieracci, M.D.
Figure 3
Figure 3
Modification of external rib plating hardware with a “U”- shaped extension over the cephalad aspect of the rib (40). This modification aligns the bicortical screws in the midportion of the rib, away from the neurovascular bundle. Additional dissection is required to use this system. Courtesy of ACUTE Innovations®.
Figure 4
Figure 4
An example of an intramedullary strut, or splint, with single point fixation (41). Courtesy of DuPuy Synthes (©DePuy Synthes 2017).
Figure 5
Figure 5
An absorbable plate adaptable for rib fixation (43). Courtesy of ACUTE Innovations®.
See this image and copyright information in PMC

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