• Int J Surg Case Rep · Apr 2021

    Case Reports

    Surgical stabilization of severe flail chest with Judet and Sanchez-Lloret plates. A case report.

    • Alessandro Stefani, Francesco Tormen, Adriana Scamporlino, Pamela Natali, Giorgio Cavallesco, and Uliano Morandi.
    • Division of Thoracic Surgery, University of Modena and Reggio Emilia, Modena, Italy. Electronic address: Alessandro.stefani@unimore.it.
    • Int J Surg Case Rep. 2021 Apr 1; 81: 105805.

    IntroductionFlail chest is now usually treated by conservative methods and surgical fixation remains indicated in selected cases. Different techniques can be used for fixation. The aim of this paper is to present a case in which Judet and Sanchez-Loret plates were employed and to discuss the usefulness of this traditional technique.Presentation Of CaseA 79-year-old woman was admitted for left thoracic trauma with severe antero-lateral flail chest. She was affected by COPD with chronic respiratory failure, ischemic heart disease, autoimmune thrombocytopenia treated on chronic steroid therapy and severe osteoporosis. CT-scan detected multiple rib fractures, left hemothorax and lung contusions. An initial conservative treatment of flail chest involved compressive bandage and then internal pneumatic stabilization in ICU, but it failed. The patient underwent successful surgical treatment of the flail chest by fixation of the anterior fractures from the second to the eight rib. Judet and Sanchez-Lloret plates were used. A bilateral pneumonia developed during the rehabilitation period and the patient died two months after operation.DiscussionJudet and Sanchez-Lloret plates represent a traditional technique for fixation of flail chest. This technique is less and less used and progressively replaced by newer materials, especially titanium plates with screws or intramedullary struts. Our patient had multiple comorbidities and a very fragile bones that advised against use of screws or intramedullary struts.ConclusionJudet and Sanchez-Lloret plates can be still considered a useful tool for the fixation of flail chest in cases of thin and fragile bones.Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.

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