Mitev Konstantin, Neziri Dashurie, Stoicovski Emil, Mitrev Zan
Department of Orthopedic Surgery, Zan Mitrev Clinic, Skopje, Republic of Macedonia.
Faculty of Medical Sciences, University Goce Delchev, Shtip, Republic of Macedonia.
J Med Case Rep. 2018 May 29;12(1):150. doi: 10.1186/s13256-018-1683-2.
The healthcare system in developing countries is limited; particularly, medical specialties such as emergency and trauma medicine are underdeveloped. Consequently, trauma injuries sustained in traffic accidents result in chronic morbidity more often than similar cases in developed countries. Multiple rib fractures induce significant patient morbidity. Current international guidelines recommend a multidisciplinary, surgery-based treatment approach to achieve optimal clinical benefit.
We admitted a 41-year-old Albanian man to our emergency department following a pedestrian-vehicle accident 5 days earlier. He presented with severe upper thoracic pain, chest deformity, dyspnea, tachycardia, subcutaneous emphysema, and hematoma. Chest radiography pointed to hypoventilated lung fields and a minor pleural effusion. Computed tomographic scans indicated displaced fractures of right lateral ribs 5 -11, hyperdensity regions from bone fragments, and pulmonary contusion. The treatment consisted of surgical fixation of ribs 7-10 using titanium reconstruction plates and cortical locking screws. The patient's clinical condition rapidly improved postoperatively. Follow-up at 6 weeks confirmed a full return to preoperative daily activities and a high quality of life.
In this case report, we present a novel and promising development in the field of trauma medicine in the Republic of Macedonia. Trauma injuries can be treated via advanced multidisciplinary medical care according to international standards, allowing optimal health recovery.
发展中国家的医疗体系有限；特别是急诊和创伤医学等医学专科发展不足。因此，交通事故所致创伤损伤导致慢性发病的情况比发达国家的类似病例更为常见。多根肋骨骨折会导致患者出现严重发病情况。当前国际指南推荐采用多学科、以手术为主的治疗方法以实现最佳临床效益。
一名41岁的阿尔巴尼亚男子在5天前发生行人与车辆碰撞事故后被收入我院急诊科。他表现为严重的上胸部疼痛、胸部畸形、呼吸困难、心动过速、皮下气肿和血肿。胸部X线检查显示肺野通气不足和少量胸腔积液。计算机断层扫描显示右侧第5至11肋骨移位骨折、骨碎片高密度区域以及肺挫伤。治疗包括使用钛重建板和皮质锁定螺钉对第7至10肋骨进行手术固定。患者术后临床状况迅速改善。6周后的随访证实患者已完全恢复术前日常活动且生活质量较高。
在本病例报告中，我们展示了马其顿共和国创伤医学领域一项新颖且有前景的进展。创伤损伤可根据国际标准通过先进的多学科医疗护理进行治疗，从而实现最佳的健康恢复。
