Chest Wall Surgery:Lung cancers that grow into the chest wall and rare primary tumors of the chest wall need to be removed or resected. With modern prosthetics and meticulous surgical techniques, chest wall tumors can be removed from patients with good functional and cosmetic outcomes.
Pectus excavatum, also known as sunken or funnel chest is a congenital chest wall malformation in which several ribs and the sternum grow abnormally, producing a concave or caved-in appearance of the anterior chest wall and sternum.
NUSS BARS/ PROCEDURE
RIB PLATING FOR MULTIPLE FRACTURE RIBS/FLAIL CHEST
Blunt chest injuries are usually combined with multiple rib fractures and severe lung contusions. This can occasionally induce acute respiratory failure and prolong ventilations. In order to reduce the periods of ventilator dependency, we perform a less invasive method of fixing multiple rib fractures.
Rib fractures are commonly caused by trauma to the chest wall. Extremely painful, rib fractures can represent an isolated injury or be part of a larger multi-system injury. A rib may be fractured in one place, two places (flail), or be shattered.
Rib fractures are most commonly caused by blunt injuries to the chest caused by a car accident, fall or assault. Penetrating injuries such as gunshot wounds are a less frequent cause. When severe, rib fractures can lead to flail chest (open chest wound) and cause breathing issues, pulmonary contusion, bleeding and pneumothorax. When untreated, rib fractures will lead to serious short-term consequences such as severe pain when breathing, pneumonia and, rarely, death. Long-term consequences include chest wall deformity, chronic pain and decreased lung function.
Treatment for Rib Fractures
Pain after rib fracture is most severe two to three days after an injury. Patients with multiple fractures are often hospitalized for observation and pain control. If there is a physical deformity to the ribcage, impaired breathing may result. Ribs can take up to six months to heal.
For select patients, thoracic surgeons at Al Zahra hospital, Dubai offer a newer, more improved way of stabilizing broken ribs:
- Rib plating is an operation performed under anesthesia that involves an incision made over the broken ribs. Plates and screws are used to stabilize the broken ribs and reduce the deformity of the ribcage, while allowing patients to breathe normally.
In the past, pain medication was the primary treatment as ribs were left to heal by themselves. Patients with flail chests (a condition of several rib fractures that prevent the affected part of the chest from moving correctly during breathing) were hospitalized in an intensive care unit until their chest wall stabilized the pain on breathing decreased and their lung injury improved. Rib plating speeds up the healing process. Patients are able to wean off mechanical ventilation faster, get discharged from the hospital sooner, return to work earlier and suffer less chronic pain and chest wall deformity.