Minimally Invasive Surgical Management of Chronic Cough-Induced Rib Fracture Non-Union: A Case Report

被引:0
|
作者
Raveglia, Federico [1 ]
Libretti, Lidia [1 ]
Cioffi, Ugo [2 ]
Guttadauro, Angelo [3 ]
Petrella, Francesco [1 ]
机构
[1] IRCCS San Gerardo dei Tintori, Dept Thorac Surg, Monza, Italy
[2] Univ Milan, Dept Surg, Milan, Italy
[3] Univ Milano Bicocca, Dept Med & Surg, Milan, Italy
来源
关键词
Rib Fractures; Chest Pain; Chronic Pain; Splints; Pain Management; Postoperative Complications; QUALITY-OF-LIFE; OPERATIVE STABILIZATION; FLAIL CHEST; FIXATION; PAIN; OUTCOMES; TRIAL;
D O I
10.12659/AJCR.943222
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: Rare disease Background: Nonunion of a rib fracture can cause chronic pain, and pharmacological pain management may lead to medication dependence. This report describes a 54-year-old man with a chronic cough and painful nonunion fracture of the left posterior 8th rib, managed with minimally invasive surgery and a rib splint. Case Report: A 54-year-old man presented with chronic cough-induced left chest wall pain. Three-dimensional chest computed tomography (CT) scan showed a nonunion of a fracture of the left posterior 8th rib. After medical management failure, we proposed a surgical approach with the aim to remove the tissue comprising the nonunion, release the nerve, and stabilize the bone stumps. To avoid the adverse effects of a large incision, we designed a minimally invasive strategy based on ultrasound fracture localization and the use of an intramedullary splint. The pain disappeared immediately after surgery. The patient was discharged in 24 hours. At 6-week followup, he was still asymptomatic, and a new CT scan reconfirmed the correct splint position. From the immediate postoperative evaluation until the last follow-up visit, he consistently reported full satisfaction. Conclusions: This report has highlighted the challenges of management of chronic pain in nonunion of a rib fracture, and has described the use of a minimally invasive surgical approach. In this single case, our tailored surgical strategy achieved definitive success in pain management, minimizing postoperative complications/adverse effects and avoiding the addition of pain medications despite a 24-hour hospital stay. Our goal is to share an alternative solution for colleagues facing similar cases.
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页数:6
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