Operative Resection of a Chronic Flail Chest Nonunion Revealing Septic Pseudarthrosis: A Case Report

We report a case of chest wall resection for painful chest wall nonunion, 5 years after traumatic flail chest and a first attempt at surgical treatment. The decision was made to perform surgery again after 2 years of unsuccessful well-conducted analgesic treatment. During surgery, we found the sa...

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Main Authors: Robin Deville, Justin Issard, Anna Vayssette, Jalal Assouad
Format: Article
Language:English
Published: Korean Society for Thoracic & Cardiovascular Surgery 2023-11-01
Series:Journal of Chest Surgery
Subjects:
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author Robin Deville
Justin Issard
Anna Vayssette
Jalal Assouad
author_facet Robin Deville
Justin Issard
Anna Vayssette
Jalal Assouad
author_sort Robin Deville
collection DOAJ
description We report a case of chest wall resection for painful chest wall nonunion, 5 years after traumatic flail chest and a first attempt at surgical treatment. The decision was made to perform surgery again after 2 years of unsuccessful well-conducted analgesic treatment. During surgery, we found the same sites of pseudarthrosis and decided to perform parietectomy of the fifth, sixth, and seventh ribs. A Gore-Tex patch was used to bridge the gap created by the resection. In immediate postoperative care, the patient’s pain was quickly and sufficiently eased by stage 1 and 2 pain killers. The results of bone samples taken from the pseudarthrosis sites all found Propionibacterium acnes. Five months after surgery, the patient had considerable improvement in pain sensations. Computed tomography showed healing of ribs, the plate in place, and no sign of complications.
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spelling doaj.art-b9bf3287f9114e5e8481da2d47eb18a72023-11-02T03:06:08ZengKorean Society for Thoracic & Cardiovascular SurgeryJournal of Chest Surgery2765-16062765-16142023-11-0156644945110.5090/jcs.23.041Operative Resection of a Chronic Flail Chest Nonunion Revealing Septic Pseudarthrosis: A Case ReportRobin Deville0https://orcid.org/0009-0000-7896-9573Justin Issard1https://orcid.org/0000-0001-9051-4088Anna Vayssette2https://orcid.org/0009-0009-1701-455XJalal Assouad3https://orcid.org/0000-0003-1409-3351Assistance Publique–Hôpitaux de ParisAssistance Publique–Hôpitaux de ParisAssistance Publique–Hôpitaux de ParisAssistance Publique–Hôpitaux de ParisWe report a case of chest wall resection for painful chest wall nonunion, 5 years after traumatic flail chest and a first attempt at surgical treatment. The decision was made to perform surgery again after 2 years of unsuccessful well-conducted analgesic treatment. During surgery, we found the same sites of pseudarthrosis and decided to perform parietectomy of the fifth, sixth, and seventh ribs. A Gore-Tex patch was used to bridge the gap created by the resection. In immediate postoperative care, the patient’s pain was quickly and sufficiently eased by stage 1 and 2 pain killers. The results of bone samples taken from the pseudarthrosis sites all found Propionibacterium acnes. Five months after surgery, the patient had considerable improvement in pain sensations. Computed tomography showed healing of ribs, the plate in place, and no sign of complications.flail chestpseudarthorsisfracture fixationchest wall resectionchronic paincase report
spellingShingle Robin Deville
Justin Issard
Anna Vayssette
Jalal Assouad
Operative Resection of a Chronic Flail Chest Nonunion Revealing Septic Pseudarthrosis: A Case Report
Journal of Chest Surgery
flail chest
pseudarthorsis
fracture fixation
chest wall resection
chronic pain
case report
title Operative Resection of a Chronic Flail Chest Nonunion Revealing Septic Pseudarthrosis: A Case Report
title_full Operative Resection of a Chronic Flail Chest Nonunion Revealing Septic Pseudarthrosis: A Case Report
title_fullStr Operative Resection of a Chronic Flail Chest Nonunion Revealing Septic Pseudarthrosis: A Case Report
title_full_unstemmed Operative Resection of a Chronic Flail Chest Nonunion Revealing Septic Pseudarthrosis: A Case Report
title_short Operative Resection of a Chronic Flail Chest Nonunion Revealing Septic Pseudarthrosis: A Case Report
title_sort operative resection of a chronic flail chest nonunion revealing septic pseudarthrosis a case report
topic flail chest
pseudarthorsis
fracture fixation
chest wall resection
chronic pain
case report
work_keys_str_mv AT robindeville operativeresectionofachronicflailchestnonunionrevealingsepticpseudarthrosisacasereport
AT justinissard operativeresectionofachronicflailchestnonunionrevealingsepticpseudarthrosisacasereport
AT annavayssette operativeresectionofachronicflailchestnonunionrevealingsepticpseudarthrosisacasereport
AT jalalassouad operativeresectionofachronicflailchestnonunionrevealingsepticpseudarthrosisacasereport