Benyan AS, Ryzhov PV, Medvedchikov-Ardiya MA, Airapetova MP, Borkovsky AY. [Nuss procedure for multiple floating rib and sternum fractures].
Khirurgiia (Mosk) 2022:93-96. [PMID:
35080834 DOI:
10.17116/hirurgia202201193]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
One of the most severe forms of blunt chest trauma is multiple floating rib fractures. Incidence of this event is up to 20% of all chest injuries. Mortality rate is about 40%. Modern surgical approach involves new technologies for rib osteosynthesis and chest stabilization. These procedures can reduce mortality by 8-10%. One of the possible options for chest stabilization in victims with anterior floating fractures, including sternal fractures, is insertion of a chest plate according to the principle of Nuss procedure. The last technique is used for correction of pectus excavatum. We report our first experience of Nuss procedure in a patient with multiple trauma, floating rib fractures and sternal fracture. Surgical intervention is described in detail. The authors emphasize an important role of thoracoscopy in a patient with chest trauma. Several modern trends in surgery for chest trauma are discussed: active surgical approach for multiple floating rib fractures, combination of surgical and resuscitation methods for chest stabilization, minimized surgical trauma by using of high-tech and endoscopic surgery.
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