Chest wall stabilization using plate fixation

Our plain-English summary of Chest wall stabilization using plate fixation, by J.E. Sherman, A. Salzberg, N.M. Raskin, et al (The Annals of Thoracic Surgery, 1988).

The study

• Authors: J.E. Sherman, A. Salzberg, N.M. Raskin, E.J. Beattie
• Journal: The Annals of Thoracic Surgery
• Published: 1988;46(4):467-9
• Type of article: Case report
• Cited by: 12 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Large defects of the chest wall require stabilization of the remaining thorax to prevent paradoxical movement. A technique of fixation using rib grafts and compression plates is presented.

In plain English

This article described a surgical technique, from Beth Israel Medical Center in New York, for stabilizing the chest wall after large sections are removed. The technique used rib grafts held with small plates and screws. It did not mention asbestos. The authors described two patients. A 37-year-old man had a Grade 2 chondrosarcoma of the sternum. A 9-cm-wide section of chest wall was removed and bridged with a 14-cm rib graft fixed with plates and 2.7-mm screws. Afterward there was no flail chest, and a small wound opening on the tenth day healed after a skin graft. A 44-year-old woman had a malignant mesothelioma originating in the pleura. Thirteen months after a first chest wall resection, the tumor recurred in the right pectoralis muscle and was removed, and two rib grafts were fixed with plates. She recovered without the paradoxical chest movement returning. At the time of writing she was in her second postoperative year without evidence of recurrent disease. The authors concluded the technique is rapid but requires the plate system and familiarity with it.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: surgical technique report illustrated with two patient cases
• Who was studied: two patients treated at Beth Israel Medical Center, New York: a 37-year-old man with a sternal chondrosarcoma and a 44-year-old woman with malignant mesothelioma originating in the pleura
• Main results:
  • Patient 1 (37-year-old man): after removal of a 9-cm-wide section of anterior chest wall and fixation of a 14-cm rib graft with miniadaptation plates and 2.7-mm bicortical screws, there was no evidence of flail chest
  • Patient 1: a small dehiscence on the tenth postoperative day was covered with a split-thickness skin graft and healed uneventfully
  • Patient 2 (44-year-old woman): the tumor was a malignant mesothelioma originating in the pleura inside the right sixth rib; it recurred in the right pectoralis muscle thirteen months after the first resection and was resected
  • Patient 2: after repair with two rib grafts fixed with plates, she recovered without recurrence of paradoxical movement and, at the time of writing, was in her second postoperative year without evidence of recurrent disease
• The authors' conclusion: The authors concluded that rib graft and plate fixation for chest wall reconstruction is rapid, but that availability of the plate system, with its specialized instrumentation, and familiarity with the system are essential

Topics

Medical terms in this study, explained in our Lexicon: Thorax.

Related studies

• Chest wall resection---alloplastic replacement — L.H. Lampl, H. Loeprecht (1988)
• Chest wall resection for mesothelioma recurrence after surgery — P. Bertoglio, O. Fanucchi, et al. (2016)
• Chest wall tumour following iodized talc pleurodesis — J.W. Jackson, M.H. Bennett (1973)
• Angiosarcoma of the chest wall — T. Suzuki, S. Suzuki, et al. (1996)
• Malignant mesothelioma presenting as a giant chest, abdominal and pelvic wall mass — Z.H. Shao, X.L. Gao, et al. (2011)
• Tumor extension along chest wall tract after diagnostic intervention in malignant pleural mesothelioma — F. Chen, A. Yoshizawa, et al. (2011)

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