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Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
Published on: September 13, 2020
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Resection of Posttraumatic Rib Synostoses Resolves Pulmonary Insufficiency: A Case Report
Sophia Mavrommatis1,2, Michael C LaRoque1,2, Peter A Cole1,2,3
1Department of Orthopaedic Surgery, University of Minnesota Medical School, Minneapolis, Minnesota.
JBJS Case Connector
|September 13, 2022
Summary
Surgical removal of rib fusions effectively treated a patient's breathing difficulties caused by traumatic rib synostosis. This case provides unique pre- and post-operative pulmonary function test data for chest wall synostosis.
Area of Science:
- Orthopedics
- Thoracic Surgery
- Pulmonary Medicine
Background:
- Traumatic rib fractures can lead to heterotopic ossification and rib synostoses.
- Rib synostoses can cause restrictive lung disease, compromising ventilation.
Observation:
- A 30-year-old female patient developed extensive intercostal heterotopic ossification and multilevel, hemithoracic rib synostoses one year after open reduction and internal fixation for multiple segmental rib fractures.
- The synostoses significantly compromised the patient's ventilation.
Findings:
- Surgical excision of the multilevel, intercostal, rib synostoses and hardware removal was performed.
- Post-operative pulmonary function tests (PFTs), imaging, and patient-reported outcome scores indicated a resolution of the patient's respiratory impairment.
Implications:
- Resection of multilevel rib synostoses is an effective treatment for pulmonary restrictive disorder secondary to traumatic rib synostosis.
- This case presents the first documented prereconstructive and postreconstructive PFTs for chest wall synostosis excision, offering valuable data for future research and clinical practice.
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