title: Operative stabilization of skeletal chest injuries secondary to cardiopulmonary resuscitation in a cardiac surgical patient.
abstract: Chest injury, including sternal and rib fractures, is the most common complication of cardiopulmonary resuscitation (CPR) that usually heals spontaneously. However, a small subset of patients has fractures that need mechanical treatment. We present a case of flail chest with sternum and left anterior rib fractures secondary to CPR in a cardiac surgical patient, which was mechanically ventilated due to respiratory complications. Open reduction and operative fixation with titanium osteosynthesis plates and locking screws in sternum and ribs was performed by a thoracic surgeon assisted by an orthopaedic surgeon. Anterior plating achieved chest stability and facilitated weaning from mechanical ventilation. The patient had an uneventful postoperative course, painfree, and experienced no sternal instability or infection throughout a six-month follow-up period. Sternal instability after cardiac surgery occurs infrequently but can be challenging to manage. Titanium plate fixation is an effective method to stabilize complicated flail chest, with clinical utility in a cardiothoracic practice.
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, G. Papanikolaou General Hospital, Thessaloniki, Greece. oananiadou@gmail.com
authors.forename: Olga
authors.initials: O
authors.lastname: Ananiadou
authors.forename: Theodoros
authors.initials: T
authors.lastname: Karaiskos
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Givissis
authors.forename: George
authors.initials: G
authors.lastname: Drossos
mesh_terms: D001860:Bone Plates; D001863:Bone Screws; D006348:Cardiac Surgical Procedures; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects*; D005409:Flail Chest / Q000209:etiology / Q000601:surgery*; D005592:Fracture Fixation / Q000295:instrumentation; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012121:Respiration, Artificial; D012253:Rib Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D013249:Sternum / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D016896:Treatment Outcome