Blunt thoracic trauma

• Published in: Surgery (Oxford) 2017-05, Vol.35 (5), p.262-268
• Main Authors: Fallouh, Hazem, Dattani-Patel, Rikesh, Rathinam, Sridhar
• Format: Article
• Language: English
• Subjects: Blunt thoracic trauma; rib fixation; Surgery; thoracic; trauma
• ISSN: 0263-9319; 1878-1764
• DOI: 10.1016/j.mpsur.2017.02.005

Abstract Blunt thoracic trauma (BTT) accounts for 98% of thoracic trauma and can be isolated or part of the polytrauma. There are two well-defined strata of patients who present with BTT. The first group are patients with high-energy injuries which tend to have multi-trauma and are critically ill. The aim in managing these patients is to identify life-threatening underlying injuries and stabilize the patients as much as possible prior to referring to thoracic surgery. Occasionally, the need for urgent surgery by a thoracic surgeon is required but in most cases minor procedures which can be performed in the emergency department (ED) of a district general hospital is warranted as a first measure prior transferring the patient. The second group are the patients with isolated low-energy thoracic trauma with rib fractures and the some of the underlying complications. The treatment of these patients tends to concentrate on respiratory support and effective analgaesia and secretion clearing strategies. Increasingly there is a trend to perform surgical fixations for multiple rib fractures to achieve better analgesia and faster recovery, and to prevent prolonged ventilation. This article offers guidance on the management of patients with blunt chest trauma prior to referring to thoracic surgery.