Deville Robin, Issard Justin, Vayssette Anna, Assouad Jalal
Department of Thoracic and Vascular Surgery, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France.
J Chest Surg. 2023 Nov 5;56(6):449-451. doi: 10.5090/jcs.23.041. Epub 2023 Sep 12.
We report a case of chest wall resection for painful chest wall nonunion, 5 years after traumatic flail chest and a first attempt at surgical treatment. The decision was made to perform surgery again after 2 years of unsuccessful well-conducted analgesic treatment. During surgery, we found the same sites of pseudarthrosis and decided to perform parietectomy of the fifth, sixth, and seventh ribs. A Gore-Tex patch was used to bridge the gap created by the resection. In immediate postoperative care, the patient's pain was quickly and sufficiently eased by stage 1 and 2 pain killers. The results of bone samples taken from the pseudarthrosis sites all found . Five months after surgery, the patient had considerable improvement in pain sensations. Computed tomography showed healing of ribs, the plate in place, and no sign of complications.
我们报告了一例因创伤性连枷胸后胸壁疼痛性骨不连而进行胸壁切除术的病例,这是首次手术治疗的5年后的再次尝试。在进行了2年的规范镇痛治疗但未成功后,决定再次进行手术。手术过程中,我们发现了相同的假关节部位,并决定切除第五、第六和第七肋骨。使用了戈尔特斯补片来填补切除造成的间隙。在术后即时护理中,患者的疼痛通过1级和2级止痛药迅速且充分地得到缓解。从假关节部位采集的骨样本结果均显示…… 术后五个月,患者的疼痛感有了显著改善。计算机断层扫描显示肋骨愈合、钢板在位且无并发症迹象。