[Treatment in unstable thorax. Case report]
Juan Matus Jiménez1, Gustavo Carbajal Aguilar, Juan Francisco Alonso Macías
1Hospital General "La Villa". jmatusj@hotmail.com
Acta Ortopedica Mexicana
|August 5, 2008
Summary
A severe chest injury involving bilateral costochondral joint luxation required immediate stabilization and surgical intervention. This case highlights a successful treatment approach for a floating sternum, enabling patient recovery and return to daily activities.
Area of Science:
- Trauma Surgery
- Thoracic Surgery
- Orthopedic Surgery
Background:
- Costochondral joint luxation is a rare but severe chest wall injury.
- Traumatic injuries to the sternum and costochondral joints can lead to significant respiratory compromise.
- Management of extensive chest wall disruption requires careful surgical planning and execution.
Observation:
- A 45-year-old male sustained bilateral luxation of all costochondral joints and a floating sternum after a workplace accident.
- The patient presented with ventilatory compromise, necessitating intubation and positive pressure ventilation.
- Initial management included temporary fixation of costochondral joints with sutures.
Findings:
- A novel surgical technique involving sternal anchors and an external aluminum support was employed for definitive fixation.
- The patient demonstrated successful lung reexpansion under positive pressure ventilation.
- Anchors were removed after four weeks, with full reintegration into labor and daily activities achieved within three months.
Implications:
- This case demonstrates the efficacy of a specific surgical fixation method for severe bilateral costochondral luxation and floating sternum.
- The described technique offers a viable solution for complex chest wall reconstruction, promoting functional recovery.
- Successful outcomes underscore the importance of advanced surgical stabilization in managing life-threatening thoracic trauma.
Related Concept Videos
01:26Flail Chest-II
Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
Assessment:
1. Clinical Evaluation:
History:
01:27Pneumothorax-II
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
01:26Pneumothorax-I
A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
01:24Flail Chest-I
Overview of Flail Chest
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
01:26Endoscopic Studies II: Thoracocentesis
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...