| Problems caused by the unstable thoracic wall and by cardiac injury due to blunt injury. | |
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MedLine Citation:
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PMID: 3770934 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The treatment of flail chest remains highly controversial. In the literature convincing arguments can be found to support any therapeutic procedure. Newer concepts of mechanical ventilation such as SIMV and CPAP, as well as the use of epidural analgesia, have resulted in a significant reduction in the duration of artificial ventilation. Although the mechanical problems are generally overestimated in this situation, the use of a ventilator is indicated in many cases because of the associated lung damage. Internal fixation of the unstable thoracic wall is restricted to special, selected cases which would otherwise require artificial ventilation, without severe lung injury and without head injury. We found stabilization of bilateral parasternal rib fractures with a retrosternal Sulamaa bar most helpful. Cardiac injuries were present in 16 per cent of our patients admitted after severe blunt thoracic injury. Most of these had myocardial contusion. The analysis of 108 cases of cardiac contusion revealed that every possible variation of ECG can be observed. Repolarization disturbances and impairment of the cardiac rhythm and the conduction system were found most frequently. A ratio of CPK-MB: total CPK of over 6 per cent provides a very significant suspicion of myocardial contusion. The clinical course is characterized by cardiac rhythm disturbances, which required treatment in 40 out of 108 patients, and to a minor extent by heart failure for which treatment was required in 17 patients. Prognosis is generally good with adequate treatment. |
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Authors:
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W Glinz |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Injury Volume: 17 ISSN: 0020-1383 ISO Abbreviation: Injury Publication Date: 1986 Sep |
Date Detail:
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Created Date: 1986-12-12 Completed Date: 1986-12-12 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0226040 Medline TA: Injury Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 322-6 Citation Subset: IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Analgesia Contusions / diagnosis, therapy Epidural Space Flail Chest / complications, therapy* Heart Injuries / diagnosis, etiology*, therapy Humans Respiration, Artificial Respiratory Tract Diseases / etiology Rib Fractures / therapy Thoracic Injuries / therapy* Thoracic Surgery Wounds, Nonpenetrating / complications, therapy* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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