Rib Fracture Repair: Indications,Technical Issues,and Future Directions |
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Authors: | Raminder Nirula Jr" target="_blank">Jose J DiazJr Donald D Trunkey John C Mayberry |
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Institution: | (1) Surgery, Burns/Trauma/Critical Care Section, University of Utah, Saltlake City, UT, USA;(2) Surgery, Division of Trauma, Emergency General Surgery, and Surgical Critical Care, Vanderbilt University, Nashville, TN, USA;(3) Department of Surgery, Oregon Health & Science University, Portland, OR, USA |
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Abstract: | Rib fracture repair has been performed at selected centers around the world for more than 50 years; however, the operative
indications have not been established and are considered controversial. The outcome of a strictly nonoperative approach may
not be optimal. Potential indications for rib fracture repair include flail chest, painful, movable rib fractures refractory
to conventional pain management, chest wall deformity/defect, rib fracture nonunion, and during thoracotomy for other traumatic
indication. Rib fracture repair is technically challenging secondary to the human rib’s relatively thin cortex and its tendency
to fracture obliquely. Nonetheless, several effective repair systems have been developed. Future directions for progress on
this important surgical problem include the development of minimally invasive techniques and the conduct of multicenter, randomized
trials. |
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