Comminuted Paraspinal Rib Fractures with Resultant Impending Penetrating Aortic Injury Requiring Costovertebral Rib Fixation: A Case Report
<i>Background and Objectives</i>: Rib fractures are common in patients with trauma, and patients with multiple rib fractures often require surgical stabilization. Because rib fractures may occur at different sites along the ribs, the technical approach to surgical stabilization varies. H...
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MDPI AG
2024-12-01
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| author | Soon-Ki Min Tae-Seok Jeong Yang-Bin Jeon |
| author_facet | Soon-Ki Min Tae-Seok Jeong Yang-Bin Jeon |
| author_sort | Soon-Ki Min |
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| description | <i>Background and Objectives</i>: Rib fractures are common in patients with trauma, and patients with multiple rib fractures often require surgical stabilization. Because rib fractures may occur at different sites along the ribs, the technical approach to surgical stabilization varies. Here, we present a case of posterior rib fractures with multiple paraspinal fragmented rib segments that were successfully treated with costovertebral plate fixation. <i>Case Presentation</i>: A truck driver was injured after falling from the top of a truck. Computed tomography scans of the chest showed multiple flail segments along the paraspinal and posterolateral regions with a clinically evident flail chest. Owing to the proximity of the flail segments to the thoracic spine, rib plating was performed across the ribs and the transverse processes of the thoracic spine with the assistance of a neurosurgeon. The patient was extubated on postoperative day 1 and discharged successfully after the other traumatic injuries were treated. <i>Discussion</i>: Far posterior rib fractures close to the spine may be challenging, particularly if plates for rib fractures cannot be placed on the ribs alone. For such challenges, costotransverse plating is a feasible surgical option. However, the anatomical orientation of the rib and the transverse process of the thoracic spine are different, which complicates surgical planning and maneuvers. Therefore, a thorough understanding of the costotransverse anatomy is critical for successful surgical stabilization of fractured ribs. <i>Conclusions</i>: This is a good example of a challenging case of rib fractures requiring paraspinal plate stabilization. |
| format | Article |
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| language | English |
| publishDate | 2024-12-01 |
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| spelling | doaj-art-068bc1ccf86e48b4808a499d7198448c2025-08-20T02:39:41ZengMDPI AGMedicina1010-660X1648-91442024-12-016012206310.3390/medicina60122063Comminuted Paraspinal Rib Fractures with Resultant Impending Penetrating Aortic Injury Requiring Costovertebral Rib Fixation: A Case ReportSoon-Ki Min0Tae-Seok Jeong1Yang-Bin Jeon2Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon 21565, Republic of KoreaDepartment of Traumatology, Gachon University College of Medicine, Incheon 21565, Republic of KoreaDepartment of Traumatology, Gachon University College of Medicine, Incheon 21565, Republic of Korea<i>Background and Objectives</i>: Rib fractures are common in patients with trauma, and patients with multiple rib fractures often require surgical stabilization. Because rib fractures may occur at different sites along the ribs, the technical approach to surgical stabilization varies. Here, we present a case of posterior rib fractures with multiple paraspinal fragmented rib segments that were successfully treated with costovertebral plate fixation. <i>Case Presentation</i>: A truck driver was injured after falling from the top of a truck. Computed tomography scans of the chest showed multiple flail segments along the paraspinal and posterolateral regions with a clinically evident flail chest. Owing to the proximity of the flail segments to the thoracic spine, rib plating was performed across the ribs and the transverse processes of the thoracic spine with the assistance of a neurosurgeon. The patient was extubated on postoperative day 1 and discharged successfully after the other traumatic injuries were treated. <i>Discussion</i>: Far posterior rib fractures close to the spine may be challenging, particularly if plates for rib fractures cannot be placed on the ribs alone. For such challenges, costotransverse plating is a feasible surgical option. However, the anatomical orientation of the rib and the transverse process of the thoracic spine are different, which complicates surgical planning and maneuvers. Therefore, a thorough understanding of the costotransverse anatomy is critical for successful surgical stabilization of fractured ribs. <i>Conclusions</i>: This is a good example of a challenging case of rib fractures requiring paraspinal plate stabilization.https://www.mdpi.com/1648-9144/60/12/2063rib fracturecostovertebral rib fixationcostotransverse plate fixationblunt thoracic trauma |
| spellingShingle | Soon-Ki Min Tae-Seok Jeong Yang-Bin Jeon Comminuted Paraspinal Rib Fractures with Resultant Impending Penetrating Aortic Injury Requiring Costovertebral Rib Fixation: A Case Report Medicina rib fracture costovertebral rib fixation costotransverse plate fixation blunt thoracic trauma |
| title | Comminuted Paraspinal Rib Fractures with Resultant Impending Penetrating Aortic Injury Requiring Costovertebral Rib Fixation: A Case Report |
| title_full | Comminuted Paraspinal Rib Fractures with Resultant Impending Penetrating Aortic Injury Requiring Costovertebral Rib Fixation: A Case Report |
| title_fullStr | Comminuted Paraspinal Rib Fractures with Resultant Impending Penetrating Aortic Injury Requiring Costovertebral Rib Fixation: A Case Report |
| title_full_unstemmed | Comminuted Paraspinal Rib Fractures with Resultant Impending Penetrating Aortic Injury Requiring Costovertebral Rib Fixation: A Case Report |
| title_short | Comminuted Paraspinal Rib Fractures with Resultant Impending Penetrating Aortic Injury Requiring Costovertebral Rib Fixation: A Case Report |
| title_sort | comminuted paraspinal rib fractures with resultant impending penetrating aortic injury requiring costovertebral rib fixation a case report |
| topic | rib fracture costovertebral rib fixation costotransverse plate fixation blunt thoracic trauma |
| url | https://www.mdpi.com/1648-9144/60/12/2063 |
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