14. Scapula fractures

Figure 4. PA radiography, thorax CT and surgical fixation of the ribs of a patient with left multiple rib fractures developed following blunt thoracic trauma, and the post-operative appearance of the patient's skin incision scar.

106 Trauma Surgery

As the scapula is a thick bone and is well-protected by the muscles in the chest wall, scapula fractures only develop as a result of high-energy trauma. Scapula fractures can be diagnosed with a direct lung radiography or thoracic CT, and may be accompanied by brachial plexus injuries. For treatment, the shoulder is strapped and immobilized. Scapula fractures rarely require surgical treatment [26, 31].

organs into thoracic cavity, abnormal positioning of the nasogastric tube, direct contact of the posterior of the ribs with such organs as the liver and stomach, and injuries that progress from one side of the diaphragm towards the other side [9, 41, 42]. In cases where, despite all investigations, there is still suspicion, a thoracoscopy and/or laparoscopy can be performed

Emergency and Current Approaches to Thoracic Traumas

http://dx.doi.org/10.5772/intechopen.74713

109

A thoracoscopy is performed to evaluate intrathoracic structures in elective conditions, and is not recommended for emergency situations [22]. It is a minimally invasive method used to clean clots from inside the thorax, to visualize diaphragm injuries, to examine the pericardium, and to remove foreign objects, to control bleeding and for the insertion of a chest tube. The

Patients with thoracic trauma should be evaluated quickly. Life-saving interventions should be implemented by the emergency physician and/or ambulance physician in the event of primary life-threatening injuries. In addition, a thoracotomy should be carried out by a thorax surgeon on site, and possible complications arising out of the specific situation should be considered. It is important to keep equipment ready and available in the event of chest surgery, and to take precautions based on the cause and severity of the trauma without losing time to distinguish

Thoracic Surgery Department, Istanbul Training and Research Hospital, Health Sciences

[1] Esposito TJ, Brasel KJ. Epidemiology chapter 2. In: Mattox KL, Feliciano DV, Moore EE,

[2] Global Status Report on Road Safety 2015. World Health Organization; 2015

patient must be stable enough to tolerate a double-lumen intubation [42, 43].

between multiple traumas and isolated thoracic traumas.

Address all correspondence to: drturkandbs@yahoo.com

editors. Trauma. 7th ed. Mc Graw-Hill; 2013. pp. 19-22

during the same session.

16. Thoracoscopy

17. Conclusion

Author details

University, Istanbul, Turkey

Turkan Dubus

References
