Clinical Challenges in Trauma Surgery: Traumatic Rib Fractures

Behind The Knife: The Surgery Podcast

Science, Health & Fitness, Medicine, Education

4.8 • 1.4K Ratings

🗓️ 6 October 2022

⏱️ 22 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this episode, our team discusses the management of traumatic rib fractures including pearls and pitfalls. Join as we discuss the current standards of treatment as well as controversies in how to manage these patients!

Hosts:
Elliott R. Haut, MD, PhD, a senior, nationally recognized name in trauma and acute care surgery at Johns Hopkins University. Dr. Haut is a past president of The Eastern Association for the Surgery of Trauma (EAST) and incoming editor-in-chief of Trauma Surgery and Acute Care Open.
Marcie Feinman, MD, MEHP, the current program director of General Surgery Residency at Sinai Hospital of Baltimore and editorial board member of SCORE. She received her Masters in Education in the Health Professions from Johns Hopkins.
David Sigmon, MD, MMEd, a PGY-7 resident at the University of Illinois at Chicago who will be a fellow at Lincoln Medical Center in the Bronx next year. He did two years of research in surgical education at the University of Pennsylvania where he also received his Master’s in Medical Education.

LITERATURE

Terry SM, Shoff KA, Sharrah ML. Improving blunt chest wall injury outcomes: introducing the pic score. J Trauma Nurs. 2021;28(6):386-394.
https://pubmed.ncbi.nlm.nih.gov/34766933/
Witt CE, Bulger EM. Comprehensive approach to the management of the patient with multiple rib fractures: a review and introduction of a bundled rib fracture management protocol. Trauma Surg Acute Care Open. 2017;2(1):e000064.
https://tsaco.bmj.com/content/2/1/e000064
Utter GH, McFadden NR. Rib fractures, the evidence supporting their management, and adherence to that evidence base. JAMA Netw Open. 2020;3(3):e201591-e201591.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2763488
Dehghan N, Nauth A, Schemitsch E, et al. Operative vs nonoperative treatment of acute unstable chest wall injuries: a randomized clinical trial. JAMA Surgery. Published online September 21, 2022.
https://jamanetwork.com/journals/jamasurgery/article-abstract/2796556
Kasotakis G, Hasenboehler EA, Streib EW, et al. Operative fixation of rib fractures after blunt trauma: A practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2017;82(3):618-626.
https://pubmed.ncbi.nlm.nih.gov/28030502/

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Transcript

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0:00.0	Behind the Knife, the Surgery Podcast, relevant and engaging content designed to help you
0:12.0	dominate the day.
0:23.2	Welcome to Behind the Knife Trauma Edition.
0:25.9	This is our team's fifth podcast, and we are excited to continue to share our expertise
0:30.3	in trauma with you.
0:32.0	My name is Marcy Feynman, and I am a trauma-necute care surgeon in Baltimore, Maryland, as
0:36.4	well as the General Surgery Residency Program Director at Sinai Hospital.
0:40.4	I am joined by Dr. David Sigmund, PGY5 at University of Illinois at Chicago and Education
0:46.0	Guru, as well as Dr. Elliott Hout.
0:49.2	Trauma surgeon extraordinaire from Johns Hopkins, past president of East and incoming editor
0:54.4	in chief of trauma surgery and acute care open.
0:58.1	Together, we will be your host in this episode as we discuss best practices in management
1:03.4	of room fractures.
1:05.4	David, why don't you give us a case to start off?
1:08.1	Thanks for that introduction, Marcy.
1:10.4	So in today's case, we have a 36-year-old woman with no significant past medical or surgical
1:15.0	history, who unfortunately crashed her bike into a curve while riding to work.
1:19.9	She was brought to the emergency room in stable condition, and it was actually the emergency
1:23.6	room team that worked her up.
1:25.3	Her ABCs were clear.
1:26.9	There were no additional findings on the secondary survey.
1:30.2	The chest x-ray identified four left-sided rib fractures, rib six through nine.
	...

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