Posterior chest wall reconstruction: A novel approach

Abstract

Traditional access for open reduction internal fixation (ORIF) of posterior rib fractures occurs through either a posterior lateral thoracotomy or posterior paramedian approach. We report the case of severe blunt chest wall injury reconstruction using the novel implementation of an Opening Wedge Thoracostomy (OWT) approach. This approach is conventionally indicated for expansion thoracostomy in the surgical management of scoliosis. The OWT approach facilitates chest wall reconstruction vis-a-vis reflection of the trapezius and latissimus dorsi muscles providing excellent exposure of the posterior thoracic cage facilitating surgical reduction and fixation. Satisfactory stability of the posterior chest is not achievable using previously described approaches. OWT approach exposure for posterior thoracic reconstruction absents the surveyed literature.