A multicenter, prospective, controlled clinical trial of surgical stabilization of rib fractures in patients with severe, nonflail fracture patterns (Chest Wall Injury Society NONFLAIL)

2020 ◽  
Vol 88 (2) ◽  
pp. 249-257 ◽  
Author(s):  
Fredric M. Pieracci ◽  
Kiara Leasia ◽  
Zach Bauman ◽  
Evert A. Eriksson ◽  
Lawrence Lottenberg ◽  
...  
Injury ◽  
2021 ◽  
Author(s):  
Fredric M. Pieracci ◽  
Sebastian Schubl ◽  
Mario Gasparri ◽  
Patrick Delaplain ◽  
Jordan Kirsch ◽  
...  

2021 ◽  
Vol 30 (5) ◽  
pp. 385-390
Author(s):  
Marissa Di Napoli ◽  
William B. DeVoe ◽  
Stuart Leon ◽  
Bruce Crookes ◽  
Alicia Privette ◽  
...  

Background Rib fractures are common after motor vehicle collisions. The hormonal changes associated with pregnancy decrease the stiffness and increase the laxity of cartilage and tendons. The effect of these changes on injury mechanics is not completely understood. Objectives To compare the incidences of chest wall injury following blunt thoracic trauma between pregnant and nonpregnant women. Methods The authors conducted a retrospective review of female patients seen at a level I trauma center from 2009 to 2017 after a motor vehicle collision. Patient characteristics were compared to determine if pregnancy affected the incidence of chest wall injury. Statistics were calculated with SPSS version 24 and are presented as mean (SD) or median (interquartile range). Results In total, 1618 patients were identified. The incidence of rib/sternal fracture was significantly lower in pregnant patients (7.9% vs 15.2%, P = .047), but the incidence of intrathoracic injury was similar between the groups. Pregnant and nonpregnant patients with rib/sternal fractures had similar Injury Severity Score results (21 [13-27] vs 17 [11-22], P = .36), but pregnant patients without fractures had significantly lower scores (1 [0-5] vs 4 [1-9], P < .001). Conclusions Pregnant patients have a lower rate of rib fracture after a motor vehicle collision than nonpregnant patients. The difference in injury mechanics may be due to hormonal changes that increase elasticity and resistance to bony injury of the ribs. In pregnant trauma patients, intrathoracic injury without rib fracture should raise concerns about injury severity. A multicenter evaluation of these findings is needed.


2020 ◽  
Vol 5 (1) ◽  
pp. 11
Author(s):  
JodyM Kaban ◽  
JohnP Skendelas ◽  
ErinR Lewis ◽  
Babak Sarani ◽  
MauricioVelasquez Galvis ◽  
...  

2017 ◽  
Vol 42 (2) ◽  
pp. 401-408 ◽  
Author(s):  
Fredric M. Pieracci ◽  
Suresh Agarwal ◽  
Andrew Doben ◽  
Adam Shiroff ◽  
Larwence Lottenberg ◽  
...  

Author(s):  
Federico Coccolini ◽  
Michelle Hamel ◽  
Francesco Favi ◽  
John Mayberry

2019 ◽  
Vol 87 (6) ◽  
pp. 1282-1288 ◽  
Author(s):  
Peter T.M. Clarke ◽  
Rosalind B. Simpson ◽  
Jessica R. Dorman ◽  
William J. Hunt ◽  
John G. Edwards

2021 ◽  
Vol 6 (1) ◽  
pp. e000626
Author(s):  
Jeff Choi ◽  
Ananya Anand ◽  
Katherine D Sborov ◽  
William Walton ◽  
Lawrence Chow ◽  
...  

BackgroundEmerging evidence suggests older adults may experience subtle hemothoraces that progress over several days. Delayed progression and delayed development of traumatic hemothorax (dHTX) have not been well characterized. We hypothesized dHTX would be infrequent but associated with factors that may aid prediction.MethodsWe retrospectively reviewed adults aged ≥50 years diagnosed with dHTX after rib fractures at two level 1 trauma centers (March 2018 to September 2019). dHTX was defined as HTX discovered ≥48 hours after admission chest CT showed either no or ‘minimal/trace’ HTX. Two blinded, board-certified radiologists reviewed inpatient chest imaging and classified injury patterns according to Chest Wall Injury Society (CWIS) taxonomy. Descriptive analysis was performed for demographic and hospitalization characteristics.ResultsWe identified 14 patients with pooled dHTX rate of 1.3%. After initial chest CT negative for concerning hemothoraces, the patients did not undergo follow-up imaging until new symptoms (shortness of breath, chest pain) developed: eight (57%) were not diagnosed until after discharge from initial hospitalization (mean (range): 9 (2–20) days after discharge). Aspirin and/or anticoagulants were involved in fewer than half of cases (43%). According to CWIS taxonomy, all patients had a series of posterolateral fractures with at least one offset or displaced fracture, and an average of six consecutive rib fractures. All patients underwent tube thoracostomy and six patients (42%)—all aged <65—underwent operative interventions.DiscussionPreliminary data suggest older adults with rib fractures may be at risk of experiencing delayed progression of trace hemothoraces or a delayed presentation of hemothoraces. Asymptomatic progression or readmission to other services/hospitals likely occurs and true dHTX rates are likely higher. Our preliminary findings suggest a possible anatomic explanation for severe chest wall injury patterns’ association with dHTX. Further characterization and capturing the true incidence of dHTX first requires wider recognition of this complication.


2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ashton B. Christian ◽  
Patrick T. Delaplain ◽  
Areg Grigorian ◽  
Jeffry Nahmias ◽  
Lukas Mueller ◽  
...  

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