Traumatic thoracic rib cage and chest wall hernias: A review and discussion of management principles

Am J Surg. 2021 Jun;221(6):1238-1245. doi: 10.1016/j.amjsurg.2021.03.024. Epub 2021 Mar 20.

Abstract

Traumatic thoracic or chest wall hernias are relatively uncommon but highly challenging injuries that can be seen after a variety of injury mechanisms. Despite their description throughout history there remains scant literature on this topic that is primarily limited to case reports or series. Until recently, there also has been no effort to create a reliable grading system that can assess severity, predict outcomes, and guide the choice of surgical repair. The purpose of this article is to review the reported literature on this topic and to analyze the history, common injury mechanisms, likely presentations, and optimal management strategies to guide clinicians who are faced with these challenging cases. We also report a modified and updated version of our previously developed grading system for traumatic chest wall hernias that can be utilized to guide surgical management techniques and approaches.

Keywords: Chest wall hernia; Hernia repair; Lung hernia; Rib fixation; Thoracic trauma.

Publication types

  • Review

MeSH terms

  • Hernia / diagnosis
  • Hernia / diagnostic imaging
  • Hernia / etiology*
  • Herniorrhaphy / methods
  • Humans
  • Lung Diseases / etiology
  • Lung Diseases / surgery
  • Radiography, Thoracic
  • Rib Cage / injuries*
  • Rib Cage / surgery
  • Thoracic Wall* / injuries
  • Thoracic Wall* / surgery