Encyclopedia of Intensive Care Medicine

2012 Edition
| Editors: Jean-Louis Vincent, Jesse B. Hall

Chest Wall Stabilization

Reference work entry
DOI: https://doi.org/10.1007/978-3-642-00418-6_388
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Synonyms

 Fixation or repair;  Flail chest stabilization;  Rib and/or sternal fracture operative reduction and internal fixation (ORIF)

Definition

Chest wall stabilization is a surgical procedure in which rib and/or sternal fractures are reduced (i.e., the fracture ends are realigned and brought into proximity) and the fractures are fixated with a plating system.

Pre-existing Condition

Chest wall injury syndromes for which operative intervention may be indicated are listed in Table  1. Category recommendations are based upon review of literature and upon the authors’ experience.
Chest Wall Stabilization. Table 1

Recommendations for chest wall stabilization for each indication

Chest wall injury

Category recommendation

Flail chest

II

Chest wall implosion syndrome

II

Chest wall defect/pulmonary herniation

I

Intractable acute pain with displaced fractures

III

Thoracotomy for other (“on the way out”)

III

Displaced or comminuted acute sternal fracture

III

Rib or sternal fracture nonunion...
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References

  1. 1.
    Tanaka H, Yukioka T, Yamaguti Y, et al (2002) Surgical stabilization of internal pneumatic stabilization? A prospective randomized study of management of severe flail chest patients. J Trauma 52(4):727–732; discussion 32PubMedGoogle Scholar
  2. 2.
    Marasco S, Cooper J, Pick A, Kossmann T (2009) Pilot study of operative fixation of fractured ribs in patients with flail chest. ANZ J Surg 79(11):804–808PubMedGoogle Scholar
  3. 3.
    Solberg BD, Moon CN, Nissim AA, Wilson MT, Margulies DR (2009) Treatment of chest wall implosion injuries without thoracotomy: technique and clinical outcomes. J Trauma 67(1):8–13; discussionPubMedGoogle Scholar
  4. 4.
    Mayberry JC, Ham LB, Schipper PH, Ellis TJ, Mullins RJ (2009) Surveyed opinion of American trauma, orthopedic, and thoracic surgeons on rib and sternal fracture repair. J Trauma 66:875–879PubMedGoogle Scholar
  5. 5.
    Richardson JD, Franklin GA, Heffley S, Seligson D (2007) Operative fixation of chest wall fractures: an underused procedure? Am Surg 73(6):591–596; discussion 6–7PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Department of SurgeryOregon Health & Science UniversityPortlandUSA
  2. 2.Trauma/Critical CareOregon Health & Science UniversityPortlandUSA