The overview presents the current situation in the diagnostics and therapy of unstable thoracic wall injuries. The diagnostic spectrum is enlarged by multidetector computed tomography with 3D reconstruction imaging in rib fractures. The use of MDCT in routine examination of blunt thoracic injuries proved to bet the most sensitive imaging method in rib fractures detection, including their dislocations and assessment of the extent of thoracic wall deformity. MDCT improves visualization of the thoracic wall injuries, thus facilitating assessment of the potential respiratory disorder significance. Non-surgical therapy is, as a standard, indicated in patients with thoracic wall injuries. The treatment includes respiratory tract hygiene, pain management and selective ventilatory support. Relative indications for surgical stabilization of fractures include block and serial rib fractures, thoracic deformities and defects and rib fractures healing disorders combined with other limiting criteria. Surgical stabilization is technically managed using metal or absorbable plasters. Surgery with open reduction and internal rib fixation, in particular in block or serial rib fractures, is associated with reduction of ventilation support time and reduction in the risk of infection.
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Sci Rep
January 2025
University of Ulsan, 93 Daehak-ro, Nam-gu, Ulsan, 680-749, Republic of Korea.
This study employed large eddy simulation (LES) with the wall-adapting local eddy-viscosity (WALE) model to investigate transitional flow characteristics in an idealized model of a healthy thoracic aorta. The OpenFOAM solver pimpleFoam was used to simulate blood flow as an incompressible Newtonian fluid, with the aortic walls treated as rigid boundaries. Simulations were conducted for 30 cardiac cycles and ensemble averaging was employed to ensure statistically reliable results.
View Article and Find Full Text PDFJ Clin Med
January 2025
Department of Surgery IV, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania.
: Totally endoscopic techniques have become increasingly popular in cardiac surgery, with minimally invasive mitral valve repair emerging as an effective alternative to median sternotomy. This approach could be particularly advantageous for patients with Noonan syndrome, who often present with structural thoracic anomalies and other comorbidities like bleeding disorders. Endoscopic mitral valve surgery is rapidly establishing itself as the new standard of care for mitral valve operations, demonstrating both safety and efficacy.
View Article and Find Full Text PDFJ Clin Med
January 2025
Department of Plastic and Reconstructive Surgery, Chonnam National University Hospital, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Republic of Korea.
: Spontaneous chest wall hematomas are rare but potentially life-threatening complications, particularly in patients with multiple comorbidities such as those undergoing hemodialysis. This case report aims to highlight the significance of early diagnosis and appropriate management in preventing complications associated with this condition. : We report the case of a 79-year-old man with end-stage renal disease on hemodialysis, presenting with a large spontaneous hematoma (18.
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View Article and Find Full Text PDFLife (Basel)
December 2024
Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padova, Italy.
The evolution of regional anesthesia techniques has markedly influenced the management of postoperative pain, particularly in thoracic surgery. As part of a multimodal analgesic approach, fascial plane blocks have gained prominence due to their efficacy in providing targeted analgesia with minimal systemic side effects. Among these, the superficial intercostal plane (SPIP) block and deep parasternal intercostal plane (DPIP) block are of notable interest.
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