Dr. William Long III presented a challenging case of a shotgun blast to the chest with defects that required spanning large rib defects, unique mechanical ventilation techniques, and treatment for lead poisoning. Dr. Tom White described a fascinating case of first rib non-union which he repaired with the assistance of 3D printing and a pre-bent plate, with excellent functional results.
Dr. Zach Warriner presented a challenging case of a patient with broken ribs after getting kicked in the side by a horse who later developed intercostal nerve entrapment with subsequent intercostal neuralgias. Dr. Steve Briggs discussed a clinical conundrum he was faced with - of a patient with multiple prior sternal surgeries for a congenital abnormality with a fractured sternal plate and ongoing pain. Finally, Dr. Tony Bacon provided a top-notch presentation on a tough non-union and chest wall hernia case which necessitated a modified Edwards Quilt repair.
Dr. Richard Miskimins presented a difficult case of sternal non-union after osteomyelitis from an infected traumatic sternal fracture. Drs. Mark Kryskow and Riann Robbins presented a case of traumatic lung herniation through disrupted a costochondral junction requiring repair. Dr. Colby Elder presented a unique repair of a traumatic diaphragmatic hernia which also disrupted the chest wall.
Dr. Gerard Bulter presented a patient who experienced blunt cardiac injury, an unstable spine fracture, and sternal and rib fractures that required SSRF before spine fixation. Medical student (and 2021 CWIS research presentation award winner) presented a challenging case of hardware failure after cardiopulmonary resuscitation. Dr. Jeff Choi presented a frail patient with extensive medical comorbidities who benefited from SSRF, and showed us the real-world application of the rib fracture frailty index.
Dr. Kovi Bessoff presented a case of an octogenarian with bad COPD with flail segments requiring stabilization. Dr. Evert Eriksson presented a challenging case of a patient with spastic cerebral palsy who had undergone shoulder arthroplasty who subsequently developed rib non-unions and debilitating radicular pain at the chest wall. Dr. Eriksson is seeking additional feedback from the case - if you have additional comments please email him at evert.eriksson@gmail.com.
Dr. Van Sant presented a demanding polytrauma patient with a grade V liver laceration, bilateral displaced rib fractures, and a displaced sternal fracture. Dr. Reiniak presented an engaging and challenging case of an open thorax after a motorcycle crash managed without permanent plates in a resource-limited setting. This presentation was translated in real-time by Dr. Patrick Greiffenstein.
Dr. Michael Renda described a case of penetrating thoracic injury with flail chest that instigated an invigorating discussion about plating in open wounds and soft tissue coverage. Dr. Tareq Kheirbek presented a case of a devastating seat belt injury requiring complex stabilization of the sternum and the costosternal junction. Dr. Ananya Anand presented a case of a man with a chronic intercostal hernia with costal margin rupture requiring repair with a modified Edward's patch.
Dr. Tung presented a difficult case of a patient with bilateral flail chest and multiple concomitant injuries requiring staged repair. Dr. Dantis presented a unique case of a young male with an open flail chest who was closed with a combination of polypropylene mesh, prolene sutures, and musculocutaneous flaps.
Dr. Baucom presented a case of a frail elderly patient with COPD who benefited from surgical stabilization of rib fractures. Drs. Long and Lottenberg presented and compared two cases of bilateral flail chest who underwent surgical stabilization of rib fractures. Timing of surgery and outcomes were compared.
Dr. Caroline Dunn and Dr. Adam Kaye presented a dramatic case of slipped rib syndrome requiring repair. Dr. George Phillip discussed his management of a considerable sternomanubrial dislocation. Finally, Dr. Essa AlGhunaim and Dr. Yousef Aleid presented a case illustrating the benefits of early surgical stabilization in patients with flail chest.
Dr. Stuart Chow presented a challenging case of rib non-union and possible costal margin rupture in a medically complex patient. Dr. Ashley Titan discussed the management of post-operative empyema in a post-SSRF patient with extrathoracic plates. Dr. Shahin Mohseni presented a patient with posterior rib fractures abutting the aorta which necessitated rib resection.
Dr. Andrew Nicholson presented an interesting case where stacked plates were used to address sternal fractures with adjacent rib fractures. Dr. David Hindin discussed a case of a patient with flail chest undergoing SSRF while on VV ECMO, who developed an empyema. Mr. Taylor Head presented a case of a patient with a prolonged air leak after SSRF.