Rib fixation in a blunt trauma chest patient post-CPR: Navigating dual pathologies and poor chest physiology: Case report with review of literature

Abstract

Managing blunt trauma to the chest and associated rib fractures presents a complex challenge in poly-trauma patients, with considerable mortality and morbidity risks. While the global trend favours non-operative approaches, select centres advocate for surgical stabilization using Rib-specific plating systems. This becomes especially intricate post-cardiopulmonary resuscitation, yet it emerges as a pivotal intervention with significant implications for patient outcomes. We observed positive outcomes based on our experience in the systematic management of a flail chest case, incorporating critical care and chest wall stabilization. This comprehensive approach proved instrumental in restoring cardiopulmonary dynamics, optimizing oxygenation, reducing analgesic requirements, mitigating pneumonia incidence, facilitating mechanical ventilation, expediting weaning, supporting early recovery, and demonstrating cost-effectiveness. Despite these promising results, ongoing research is imperative to fine-tune patient selection criteria and refine indications for rib fixation. This approach holds the potential to minimise morbidity and mortality in thoracic injury cases, underscoring the need for continued exploration and validation of rib-specific plating systems in the evolving landscape of trauma care.