Principles of the thoracic wall injury management]

The overview presents the current situation in the diagnostics and therapy of unstable thoracic wall injuries. The diagnostic spectrum is enlarged by multidetector computed tomography with 3D reconstruction imaging in rib fractures. The use of MDCT in routine examination of blunt thoracic injuries proved to bet the most sensitive imaging method in rib fractures detection, including their dislocations and assessment of the extent of thoracic wall deformity. MDCT improves visualization of the thoracic wall injuries, thus facilitating assessment of the potential respiratory disorder significance. Non-surgical therapy is, as a standard, indicated in patients with thoracic wall injuries. The treatment includes respiratory tract hygiene, pain management and selective ventilatory support. Relative indications for surgical stabilization of fractures include block and serial rib fractures, thoracic deformities and defects and rib fractures healing disorders combined with other limiting criteria. Surgical stabilization is technically managed using metal or absorbable plasters. Surgery with open reduction and internal rib fixation, in particular in block or serial rib fractures, is associated with reduction of ventilation support time and reduction in the risk of infection.