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

J Chest Surg. 2023 Nov 5;56(6):449-451. doi: 10.5090/jcs.23.041. Epub 2023 Sep 12.

Abstract

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.

Keywords: Case report; Chest wall resection; Chronic pain; Flail chest; Fracture Fixation; Pseudarthorsis.

Publication types

  • Case Reports

Grants and funding

Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.