Abstract：
:Although surgical fixation of rib fractures is increasingly being performed around the world, very little has been published on how to access the chest wall itself. Having performed over one hundred rib fixations in our institution in the past five years, our surgical technique has evolved as more has come to be understood about these types of injuries through examination of the literature, our own experience, and discussions with colleagues experienced in treating these patients. Retrospective chart review of our trauma registry revealed prevalent fracture patterns and we sought to describe the three simple approaches to the chest wall that we most commonly use based on these data and validated through cadaveric dissections. What follows is a description of our experience with surgical fixation and analysis of the anatomy based on functional approaches to common injury patterns. Analysis of CT scans of patients with flail chest injuries revealed the most commonly encountered in our patients requiring surgical fixation. We identified three basic incisions used to access the areas of interest in a majority of cases. Careful cadaveric dissections allowed us to provide a detailed description of what portions of the chest wall would be accessible through each with and without sparing of the chest musculature. This paper describes viable options for approaching the chest wall for most rib fracture patterns in need of surgical fixation. This is not comprehensive review, but merely presents some of the effective alternatives to a standard thoracotomy as an approach to the chest wall with the hope and expectation that future publications will expand and improve upon the techniques described here.
journal_name
J Thorac Disjournal_title
Journal of thoracic diseaseauthors
Greiffenstein P,Tran MQ,Campeau Ldoi
10.21037/jtd.2019.03.33subject
Has Abstractpub_date
2019-05-01 00:00:00pages
S1034-S1043issue
Suppl 8eissn
2072-1439issn
2077-6624pii
jtd-11-S8-S1034journal_volume
11pub_type
杂志文章,评审abstract：:Rituximab, a monoclonal antibody against CD20+ antigen specific B cell, has been increasingly used in the treatment of non-Hodgkin's lymphoma and some other autoimmune diseases, such as systemic lupus erythematosus (SLE) and rheumatoid arthritis. It is noted that Rituximab could enhanced the efficacy of CHOP-based che...
journal_title：Journal of thoracic disease
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abstract：:Surgical procedures of pleural cavity are crucial to complete the diagnoses or planning treatment of pleural effusions with an unknown aetiology. Traditionally, the transthoracic approach has been the most used procedure to study the pleural cavity. The subxiphoid video-thoracoscopy is becoming an alternative to the t...
journal_title：Journal of thoracic disease
pub_type： 杂志文章
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abstract：Background:A standardized treatment algorithm for sternoclavicular joint infection management is lacking in the literature. While major risk factors for sternoclavicular joint infection, including immunosuppression, rheumatoid arthritis, type 2 diabetes, indwelling catheters, and intravenous drug use have been identifi...
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journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.3978/j.issn.2072-1439.2014.03.18
更新日期：2014-05-01 00:00:00
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journal_title：Journal of thoracic disease
pub_type： 杂志文章,评审
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abstract：Background:Although robot-assisted minimally-invasive esophagectomy (RAMIE) surgeries are expanding clinically, few studies have reported patients with locally-advanced esophageal cancer who underwent neoadjuvant chemoradiation therapy (nCRT). Methods:From 2013 to 2017, 219 patients with esophageal squamous cell carci...
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pub_type： 杂志文章
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journal_title：Journal of thoracic disease
pub_type： 杂志文章,评审
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journal_title：Journal of thoracic disease
pub_type： 杂志文章
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journal_title：Journal of thoracic disease
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journal_title：Journal of thoracic disease
pub_type： 杂志文章
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更新日期：2016-11-01 00:00:00
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journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.3978/j.issn.2072-1439.2014.02.09
更新日期：2014-05-01 00:00:00
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journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.21037/jtd.2020.01.53
更新日期：2020-03-01 00:00:00
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journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.3978/j.issn.2072-1439.2013.05.22
更新日期：2013-06-01 00:00:00
abstract：:Liquid biopsy provides the opportunity of detecting and analyzing cancer in various body fluids. In peripheral blood, apart from circulating cell free DNA, circulating cancer cells and other tumor-associated compounds such as extracellular vesicles are also emerging candidates for detection. Compared to conventional t...
journal_title：Journal of thoracic disease
pub_type： 杂志文章,评审
doi：10.21037/jtd.2018.04.68
更新日期：2018-06-01 00:00:00
abstract：:In many areas of the world, concentrations of ambient air pollutants exceed levels associated with increased risk of acute and chronic health problems. While effective policies to reduce emissions at their sources are clearly preferable, some evidence supports the effectiveness of individual actions to reduce exposure...
journal_title：Journal of thoracic disease
pub_type： 杂志文章,评审
doi：10.3978/j.issn.2072-1439.2014.12.21
更新日期：2015-01-01 00:00:00
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journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.3978/j.issn.2072-1439.2014.07.44
更新日期：2014-09-01 00:00:00
abstract：Background:Good compliance in chronic obstructive pulmonary disease (COPD) is of 'paramount importance' in reducing the occurrence of acute exacerbations, hospitalisation and mortality and in improving quality of life. However, a number of studies have confirmed that long-term compliance is low and often associated wit...
journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.21037/jtd.2018.09.126
更新日期：2018-10-01 00:00:00
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journal_title：Journal of thoracic disease
pub_type： 杂志文章,评审
doi：10.3978/j.issn.2072-1439.2015.03.13
更新日期：2015-04-01 00:00:00
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journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.21037/jtd.2019.04.04
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journal_title：Journal of thoracic disease
pub_type： 杂志文章
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journal_title：Journal of thoracic disease
pub_type： 杂志文章,评审
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journal_title：Journal of thoracic disease
pub_type：
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journal_title：Journal of thoracic disease
pub_type： 杂志文章,评审
doi：10.3978/j.issn.2072-1439.2013.10.22
更新日期：2014-03-01 00:00:00
abstract：OBJECTIVE:Surgical use of robots has evolved over the last 10 years. However, the academic experience with robotic lung segmentectomy remains limited. We aimed to analyze our lung segmentectomy experience with robot-assisted thoracoscopic surgery. METHODS:Prospectively recorded clinical data of 21 patients who underwe...
journal_title：Journal of thoracic disease
pub_type： 杂志文章
doi：10.3978/j.issn.2072-1439.2014.06.40
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abstract：OBJECTIVE:Epidermal growth factor receptor (EGFR) mutation mostly occurred in lung adenocarcinoma, rarely in squamous cell carcinoma (SQCC). EGFR mutation rate in SQCC varied in previous reports, and the efficacy of EGFR tyrosine kinase inhibitors (TKIs) in SQCC harboring EGFR mutation has not yet been fully evaluated....
journal_title：Journal of thoracic disease
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doi：10.3978/j.issn.2072-1439.2013.09.15
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journal_title：Journal of thoracic disease
pub_type： 杂志文章
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journal_title：Journal of thoracic disease
pub_type：
doi：10.3978/j.issn.2072-1439.2014.04.22
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abstract：Background:Pulmonary arterial compliance (PAC) was previously shown to be an important prognostic factor in pulmonary arterial hypertension (PAH), in addition to the conventional pulmonary vascular resistance (PVR). The product of PAC and PVR, the arterial time (RC) constant, expresses the logarithmic relationship betw...
journal_title：Journal of thoracic disease
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abstract：Background:Although emphysema and small cell lung cancer (SCLC) are prevalent in smokers, no previous study has investigated the prognostic impact of computed tomography (CT)-determined emphysema in SCLC. This study was undertaken to analyze the prognostic value of emphysema scores as determined by baseline CT scans in...
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