Ananiadou Olga, Karaiskos Theodoros, Givissis Panagiotis, Drossos George
Department of Cardiothoracic and Vascular Surgery, G. Papanikolaou General Hospital, Thessaloniki, Greece.
Interact Cardiovasc Thorac Surg. 2010 Mar;10(3):478-80. doi: 10.1510/icvts.2009.218750. Epub 2009 Dec 10.
Chest injury, including sternal and rib fractures, is the most common complication of cardiopulmonary resuscitation (CPR) that usually heals spontaneously. However, a small subset of patients has fractures that need mechanical treatment. We present a case of flail chest with sternum and left anterior rib fractures secondary to CPR in a cardiac surgical patient, which was mechanically ventilated due to respiratory complications. Open reduction and operative fixation with titanium osteosynthesis plates and locking screws in sternum and ribs was performed by a thoracic surgeon assisted by an orthopaedic surgeon. Anterior plating achieved chest stability and facilitated weaning from mechanical ventilation. The patient had an uneventful postoperative course, painfree, and experienced no sternal instability or infection throughout a six-month follow-up period. Sternal instability after cardiac surgery occurs infrequently but can be challenging to manage. Titanium plate fixation is an effective method to stabilize complicated flail chest, with clinical utility in a cardiothoracic practice.
胸部损伤，包括胸骨和肋骨骨折，是心肺复苏（CPR）最常见的并发症，通常可自愈。然而，一小部分患者的骨折需要进行手术治疗。我们报告一例心脏手术患者因CPR继发连枷胸伴胸骨和左前肋骨骨折的病例，该患者因呼吸并发症接受机械通气。在一名骨科医生的协助下，胸外科医生对胸骨和肋骨进行切开复位并用钛接骨板和锁定螺钉进行手术固定。前路钢板固定实现了胸部稳定，并促进了机械通气的撤机。患者术后恢复顺利，无痛，在六个月的随访期内未出现胸骨不稳定或感染。心脏手术后胸骨不稳定很少发生，但处理起来可能具有挑战性。钛板固定是稳定复杂连枷胸的有效方法，在心胸外科实践中具有临床应用价值。
