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Rib Fixation for a Patient with Severely Displaced and Overlapped Costal Cartilage Fractures

  • Han, Sung Ho (Department of Traumatology, Cheju Halla General Hospital) ;
  • Chon, Soon-Ho (Department of Thoracic and Cardiovascular Surgery, Cheju Halla General Hospital) ;
  • Lee, Jong Hyun (Department of Thoracic and Cardiovascular Surgery, Cheju Halla General Hospital) ;
  • Lee, Min Koo (Department of Traumatology, Cheju Halla General Hospital) ;
  • Kwon, Oh Sang (Department of Traumatology, Cheju Halla General Hospital) ;
  • Kim, Kyoung Hwan (Department of Traumatology, Cheju Halla General Hospital) ;
  • Kim, Jung Suk (Department of Traumatology, Cheju Halla General Hospital) ;
  • Lee, Ho hyoung (Department of Traumatology, Cheju Halla General Hospital)
  • Received : 2017.09.28
  • Accepted : 2018.01.06
  • Published : 2018.04.30

Abstract

Rib fixations for flail chest or displaced rib fractures are not a new technique. However, reports on rib fixations involving costal cartilage fractures are very few and surprisingly there are no reports of internal fixations involving only the costal cartilage in the English literature. The diagnosis is difficult and the necessity of the procedure may be quite controversial. Placing plates in screws into the costal cartilage alone may seem unstable and easily dislodged or stripped through the cartilage. We report a 31-year-old male scuba diver instructor who underwent rib fixations over his 7th and 8th costal cartilage ribs for severe pain. The procedure was done with conventional plates and screws. He had the plates and screws removed 2 months later due to lingering pain, but with them removed he is now quite happy with the results without pain. The procedure for fixation of painful overlapped costal cartilage is quite simple and can be done with the usual conventional methods, fixating plate and screws directly over the cartilage alone without fixation over the bony rib.

Keywords

References

  1. Bonne SL, Turnbull IR, Southard RE. Technique for repair of fractures and separations involving the cartilaginous portions of the anterior chest wall. Chest 2015;147:e199-204. https://doi.org/10.1378/chest.14-0757
  2. Schulte K, Whitaker D, Attia R. In patients with acute flail chest does surgical rib fixation improve outcomes in terms of morbidity and mortality? Interact Cardiovasc Thorac Surg 2016;23:314-9 . https://doi.org/10.1093/icvts/ivw092
  3. Fitzpatrick DC, Denard PJ, Phelan D, Long WB, Madey SM, Bottlang M. Operative stabilization of flail chest injuries: review of literature and fixation options. Eur J Trauma Emerg Surg 2010;36:427-33. https://doi.org/10.1007/s00068-010-0027-8
  4. Nolasco-de la Rosa AL, Mosinoz-Montes R, Matehuala-Garcia J, Roman-Guzman E, Quero-Sandoval F, Reyes-Miranda AL. Unstable thorax fixation with bioabsorbable plates and screws. Presentation of some cases. Cir Cir 2015;83:23-8.
  5. Chan EG, Stefancin E, Cunha JD. Rib fixation following trauma: a cardiothoracic surgeon's perspective. J Trauma Treat 2016;5:4-7.
  6. Pieracci FM, Rodil M, Stovall RT, Johnson JL, Biffl WL, Mauffrey C, et al. Surgical stabilization of severe rib fractures. J Trauma Acute Care Surg 2015;78:883-7. https://doi.org/10.1097/TA.0000000000000581