Traumatic thoracic rib cage hernias: Operative management and proposal for a new anatomic-based grading system - 25/04/18
Abstract |
Background |
Traumatic Rib Cage Hernias (TRCH) requiring operative repair are rare and there is currently no literature to guiding surgical management.
Methods |
Perioperative review of TRCH over 32 years. Five operative grades were developed based on extent of tissue/bone damage, size, and location.
Results |
Twenty-four patients (20 blunt, 4 penetrating) underwent operative repair. Lung was the herniated organ in 88% with a median of 4 rib fractures and average size of 60.25 cm. Types of operation were well clustered by assigned TRCH grade. The majority required mesh (75%) and/or rib plating (79%). Complex tissue flap reconstruction was required in 10%. Full range-of-motion was maintained in 88% with79% returning to pre-injury activity levels. Five patients had continued pain at final follow up (mean = 7months).
Conclusion |
The size and degree of injury has important implications in the optimal surgical management of TRCHs. These operative grades effectively direct surgical care for these rare and complex injuries.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Traumatic rib cage hernias (TRCH) are rare and there is little published literature. |
• | There currently is no standardized grading system or approach to TRCH. |
• | We characterize 24 operative patients with TRCH over a 32 year period. |
• | A modified five-tiered grading system can guide operative repair of TRCH. |
Keywords : Traumatic lung hernias, Lung hernia, Rib cage hernia, Injury classification, Rib fixation
Plan
Vol 215 - N° 5
P. 794-800 - mai 2018 Retour au numéro
Article précédent
- Discussion of “Dual energy computed tomography should be the first line preoperative localization imaging test for primary hyperparathyroidism patients”
- J. David Beatty
- Discussion of “Traumatic thoracic rib cage hernias: Operative management and proposal for a new anatomic-based grading system”
- John Mayberry
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