RESUMO
BACKGROUND: Fractures of the chest wall include sternum and rib fractures. Traditionally they are managed conservatively due to the anatomy of the rib cage that allows most of them to remain stable and to form a callus that unites the fractured segments. In spite of this management, some patients present with chronic pain or instability of the wall which makes them require some type of fixation. The present article performs a literature review based on 4 cases. CLINICAL CASES: The first case was a 61 year-old man with blunt chest trauma, with a great deformity of the chest wall associated with subcutaneous emphysema, and pneumothorax. The second case was a 51 year-old man with blunt chest trauma, initially managed at another institution, who despite treatment, had persistent pain and dyspnoea. The third case was a 30 year-old man that suffered a motor vehicle accident, with resulting pain and crepitation of the rib cage and with diagnostic images showing multiple rib fractures. The last case is a 62 year-old man that fell down the stairs, with blunt chest trauma with high intensity pain, dyspnoea and basal ipsilateral hypoventilation. CONCLUSION: Rib fracture fixation offers a good alternative in selected patients to decrease associated morbidity, leading to a patient's fast return to his or her working life.
Assuntos
Fixação Intramedular de Fraturas , Fraturas das Costelas/cirurgia , Adulto , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
La causa más común de hiperparatiroidismo primario, corresponde a la presencia de un adenoma paratiroideo. Estos tumores pueden encontrarse en localizaciones atípicas como el mediastino, y tener tamaños muy variables. En el periodo posquirúrgico de algunos de estos casos puede presentarse un requerimiento alto de Calcio por los huesos, denominado síndrome de hueso hambriento, el cual puede generar crisis hipocalcémicas severas. Reportamos un caso correspondiente a una resección de un adenoma mediastinal con posterior hipocalcemia refractaria.
