DATE OF OPERATION: MM/DD/YYYY
PREOPERATIVE DIAGNOSIS: Fracture of left ribs, four through eight, with flail chest.
POSTOPERATIVE DIAGNOSIS: Fracture of left ribs, four through eight, with flail chest.
OPERATION PERFORMED: Open reduction and internal fixation (ORIF) of ribs, four through eight.
SURGEON: John Doe, MD
ANESTHESIA: General.
ESTIMATED BLOOD LOSS: 50 mL.
INDICATIONS FOR OPERATION: The patient is an (XX)-year-old patient, status post fall of about 40 feet. He fractured multiple ribs on the left side. He had significant displacement with probable flail segment, and it was felt by Dr. Jane Doe that he would benefit from stabilization of the ribs on the left side to help with his pulmonary status.
DESCRIPTION OF OPERATION: The patient was initially positioned and the approach made by Dr. Jane Doe and her team. We were called in once the approach and exposure was obtained to the left thorax.
We were able to gain access to the ribs between four and eight. The eighth rib was the segmental one that we were able to stabilize in two different places. Once the fractures were identified, the very edge was cleaned of some periosteum to get a reduction and the reduction held with basically some Hohmann retractors to keep the segments from caving in, and we used 3.5 locking Recon plates to stabilize them. It was a combination of six and seven hole plates with three screws anterior and posterior to the fracture. They were put in a locking fashion when possible; however, some of the more proximal ribs, we were not able to put locking screws in because we would not get the angle to work around the scapula. As stated, two plates were placed on the eighth rib. Afterwards, we were very pleased with the stability that was noticeably improved after plating.
We did get a chest x-ray just to check some of the position of the hardware that looked appropriate, and we then turned the case back over to Dr. Jane Doe’s team to close. They also put a chest tube in. The patient tolerated the procedure well.
