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Link to original content: https://pubmed.ncbi.nlm.nih.gov/21841952
Historic overview of treatment techniques for rib fractures and flail chest - PubMed Skip to main page content
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. 2010 Oct;36(5):407-15.
doi: 10.1007/s00068-010-0046-5. Epub 2010 Sep 23.

Historic overview of treatment techniques for rib fractures and flail chest

M Bemelman, M Poeze, T J Blokhuis, L P H Leenen

Historic overview of treatment techniques for rib fractures and flail chest

M Bemelman et al. Eur J Trauma Emerg Surg. 2010 Oct.

Abstract

Introduction: From the beginning of the twentieth century till the current time, an overview is presented of the surgical treatment for rib fractures and flail chest.

Methods: Many techniques have been used to stabilize the thorax wall. There has been no follow-up for the most described techniques and the evidence provided is at its best at L3-4. This, together with the noninvasiveness of mechanical ventilation, has made the latter the golden standard.

Conclusion: However, the recent introduction of better and fully dedicated materials provides the possibility of exploring the surgical treatment of chest injuries. The authors make a case for operative treatment of rib fractures and flail chest.

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Figures

Fig. 1
Fig. 1
Bennet® respirator. Reproduced with the permission of Jeff Weisman
Fig. 2
Fig. 2
Drinker® respirator. The patient would be positioned in the cylinder with their head inserted through a metal plate with a rubber seal. From http://commons.wikimedia.org (free of copyright)
Fig. 3
Fig. 3
The “Cape Town Limpet” is analogous to a normal sink plunger. Vacuum is created through the metal tube, which is then sealed. Traction is then applied by pulling on the metal bar. Reproduced from [39] with permission
Fig. 4
Fig. 4
Bullet forceps
Fig. 5
Fig. 5
Hook from an ordinary clothes hanger
Fig. 6
Fig. 6
Patient with the hook placed in the sternum and traction applied. Note that the weight is hanging above the patient; imagine the rope breaking or the hook being pulled out! Reproduced from [26] with permission
Fig. 7
Fig. 7
Patient with traction applied to the sternum after placing reduction forceps. Reproduced from [23] with permission
Fig. 8
Fig. 8
Troicart bent at a 90° angle; a T shape is formed after twisting one half
Fig. 9
Fig. 9
Patient with the troicart placed intercostally and fixed under traction to a board on the patient. Reproduced from [9] with permission
Fig. 10
Fig. 10
Schematic drawing made by Guernelli of where he put the “skewers” in the patient. Reproduced from [20] with permission
Fig. 11
Fig. 11
Picture of the Lunque® fixator after removal from the patient. Note the large cutter and the coupling device, which was probably positioned outside the patient. Reproduced from [31] with permission
Fig. 12
Fig. 12
Illustration from Paris showing the use of the plates. Reproduced from [34] with permission
Fig. 13
Fig. 13
Illustration from Paris showing the percutaneous placement of a plate. This could be the first illustration of a MIPO technique
Fig. 14
Fig. 14
The plate designed and used by Labitzke. Note the asymmetric joints between the clamps. Reproduced from [30] with permission
Fig. 15
Fig. 15
Judet plate; note the use of additional sutures to hold the plate in position. Reproduced from [7] with permission
Fig. 16
Fig. 16
Sanchez–Lloret plate. Reproduced from [7] with permission
Fig. 17
Fig. 17
The RibLoc® plate, manufactured by Acute Innovations™
Fig. 18
Fig. 18
Medin® plates. Reproduced from [42] with permission
Fig. 19
Fig. 19
Chest X-ray with the K wires and cerclage in situ. Reproduced from [25] with permission
See this image and copyright information in PMC

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References

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