Sternal Fractures in Blunt Chest Trauma: Retrospective Analysis of 330 Cases.

OBJECTIVE: To analyse the range of injuries associated with sternal fracture (SF) and their clinical features and outcomes. STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Department of Emergency Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey, from July 2010 to July 2020. METHODOLOGY: Sternal fractures were considered in 330 patients with blunt trauma during the study period. They were categorised according to the Johnson and Branfoot classification and the Arbeitsgemeinschaft fur Osteosynthesefragen / Orthopaedic Trauma Association classification. Demographic data were collected, including age, gender, mechanism of injury, associated injuries, and the length of hospital stay. RESULTS: During the 10-year study period, a total of 4024 thoracic trauma patients were admitted to the emergency department. Of these, 330 (8.2%) had a sternal fracture. The median age of the patients was 41 (8-90) years, and 72.7% were male. Isolated sternal fractures occurred in 93 patients (28.2%). An additional thoracic injury was observed in 74 patients (22.4%) included in the study, and an accompanying extrathoracic injury was observed in 34 patients (10.3%). In 129 patients (39.1%), both thoracic and extrathoracic pathologies were detected, in addition to SF. The mortality rate among patients with isolated sternal fracture was 1.1%; the mortality rate among patients with sternal fracture accompanied by additional pathologies was 6.6%. CONCLUSION: Sternal fractures are frequently associated with other injuries. Although isolated sternal fracture has a good prognosis, careful evaluation and clinical observation are essential for additional injuries. KEY WORDS: Emergency medicine, Sternal fracture, Chest trauma.

The 100 most-cited articles on pectus deformities: A bibliometric analysis.

BACKGROUND: In this study, we aimed to examine the development of knowledge on pectus deformities through a meticulous analysis of the 100 most-cited articles published on this topic. METHODS: Publications related to pectus deformities from January 1975 to April 2020 were scanned using the Web of Science Core Collection database. The publications were ranked from maximum to minimum according to the number of citations and were examined in detail. RESULTS: The 100 articles were published in 27 different journals and received a total of 8,290 citations. The average of the impact factors of journals in 2018 was 4.441. The mean citation density of all articles was 5.1±3.8. In the past years, a surgical technique definition and experience transfer were more frequently used, while complications and technical details were started to be presented in recent years. CONCLUSION: Our study results suggest that the studies of pectus deformities would continue and, from now on, issues such as complications and technical details would come to the forefront in the articles.

A different approach in thoracic surgery: Guillotine lobectomy.

BACKGROUND: In this study, we aimed to compare the surgical results of video-assisted thoracoscopic lobectomy with the guillotine technique to the results of conventional video-assisted thoracoscopic lobectomy. METHODS: Between January 2013 and December 2019, a total of 49 patients (20 males, 29 females; median age: 45 years; range, 11 to 73 years) who underwent video-assisted thoracoscopic lobectomy for benign lung pathologies were retrospectively analyzed. The patients were divided into two groups: the guillotine technique group (n=31) who had simultaneous cutting of the lobar artery and lobar bronchus with a single stapler, and the control group (n=18) who received conventional video-assisted thoracoscopic lobectomy. Demographic features of the patients, type of surgery, type of pulmonary resection, duration of the operation, postoperative length of hospital stay, postoperative pathological examination result, complications, and follow-up data were recorded. RESULTS: The median operation time was 142.5 (range, 60 to 237) min and 90 (range, 55 to 180) min in the control and the guillotine technique groups, respectively, indicating a statistically significant difference (p<0.05). Bronchiectasis was the most common histopathological diagnosis in both groups. No intraoperative complication, long-term complications or mortality were observed in any of the patients. CONCLUSION: The guillotine lobectomy technique significantly reduces the duration of the operation. The adventitia and connective tissue around the lobar artery and lobar bronchus enable the closure of these structures with the supporting tissue and, therefore, reinforces the staples. The guillotine technique in video-assisted thoracoscopic lobectomy seems to be a cost-effective, reliable, and practical method that provides intraoperative convenience and shortens the operation time.

Trust the Capitonnage in the Giant Cyst: Case Report.

Cyst hydatid in the lung is still a health problem for many countries. It develops in the lung and can grow into the lung parenchyma. When it is diagnosed as a giant cyst, surgery should be performed. In the surgery, capitonnage is necessary to protect the lung parenchyma.

Use of Magill Forceps to Remove Foreign Bodies in Children.

Introduction Esophageal foreign body (FB) in all age groups can cause serious morbidity or mortality. The study aims to report our experience retrieving FBs from the upper esophagus in children using Magill forceps. Materials and Methods In this study, 88 patients (45 males [51.1%] and 43 females [48.9%]) were presented with suspected FB ingestion. FB ingestion was determined via endoscopic analysis, or lateral and posterior-anterior radiographies, including oropharynx, neck, chest, and abdomen. Cases were classified into seven groups, according to history, diagnostic method, and postintervention findings, as follows: (1) coins, (2) toys, (3) metals, (4) bones, (5) battery, (6) glass, and (7) food. A laryngoscope was used to elevate the larynx and expose the esophageal entrance. Magill forceps were advanced into the esophagus and opened to observe and extract the FB. Results All 88 patients who underwent endoscopic examination due to suspected FB ingestion were confirmed to have ingested a FB. Median age was 12 years; 15 patients were aged < 5 years; 63 (71.5%) were diagnosed based on routine radiographic findings, and others were diagnosed based on physical findings and history. The most common type of FB was coins ( n = 51 [57.9%]). Mean surgical duration was 20 minutes. Conclusion FBs located at cervical esophageal level are usually the most difficult to remove. Magill forceps should be used before other methods.