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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Main Authors: Soon-Ki Min, Tae-Seok Jeong, Yang-Bin Jeon
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/60/12/2063
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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
collection DOAJ
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.
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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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AT yangbinjeon comminutedparaspinalribfractureswithresultantimpendingpenetratingaorticinjuryrequiringcostovertebralribfixationacasereport