[Pleural adhesions and deformation of the chest wall (author's transl)]

Deformation of the chest wall and pleural adhesions are some of the sequelae of chest trauma with fractures of ribs. If sufficiently extensive these lesions may result in restrictive disturbances of ventilation and partial respiratory insufficiency. In these cases marked improvement in function and perfusion can be obtained by decortication at an early stage. Follow-up examinations of 37 patients who had sustained fractures of more than 4 ribs revealed restrictive respiratory impairment in only three cases. Hypoxia was present in 11, but a causal connection with the trauma could be ascertained in only 4 persons. For assessing the extent of the lesions and the indications for decortication perfusion scanning is a "must", as it will show up pathological changes at a time when the gaseous exchange and lung function still appear normal. There seems to be no correlation between the radiological extent of the adhesions or the deformation of the thorax and the extent of changes in lung function and blood gases.