{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T06:54:56Z","timestamp":1763535296922},"reference-count":11,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,11,18]],"date-time":"2014-11-18T00:00:00Z","timestamp":1416268800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2014,11,18]],"date-time":"2014-11-18T00:00:00Z","timestamp":1416268800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2014,11,18]],"date-time":"2014-11-18T00:00:00Z","timestamp":1416268800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Rib fracture stabilization has become a more accepted practice although stabilization of the most cephalad ribs presents a unique challenge. We present our experience with use of a 90\u00b0 drill and screwdriver to bridge these difficult rib fractures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective review included patients who underwent rib fracture stabilization from August 1, 2009, through September 30, 2012. Patients were divided into two groups: those whose procedure used the 90\u00b0 device and those that did not. Data were compared using standard statistical analysis and reported as percentages and medians [interquartile ranges]. <jats:italic>P<\/jats:italic> values &lt;0.05 were considered significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 89 patients: 29 (33 %) had 90\u00b0 devices used and 60 (67 %) did not. There were no differences between groups in age, sex, Trauma\u2010Related Injury Severity Score, the presence of flail chest, occurrence of pneumonia, and intensive care unit or hospital length of stay. The Injury Severity Score was higher in the 90\u00b0 group (22 vs. 16; <jats:italic>P<\/jats:italic> = 0.03). The highest rib stabilized was different between the 2\u00a0groups (3 [2\u20135] vs. 5 [2\u20139]; <jats:italic>P<\/jats:italic> = 0.001), with more third rib stabilizations in the 90\u00b0 group (38 vs. 20 %; <jats:italic>P<\/jats:italic> = 0.04) as well as more total number of ribs fixed (5 vs. 4; <jats:italic>P<\/jats:italic> = 0.001). There was no difference in operative time between the 2\u00a0groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The surgical reach for rib fracture stabilization has been extended with use of a 90\u00b0 drill and screwdriver. High fractures under the scapula where access is technically challenging can be stabilized without prolonging operative times.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-014-2862-y","type":"journal-article","created":{"date-parts":[[2014,11,21]],"date-time":"2014-11-21T14:24:11Z","timestamp":1416579851000},"page":"789-793","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Use of a 90\u00b0 Drill and Screwdriver for Rib Fracture Stabilization"],"prefix":"10.1002","volume":"39","author":[{"given":"Terry P.","family":"Nickerson","sequence":"first","affiliation":[{"name":"Department of Surgery Mayo Clinic 200 First St SW 55905 Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian D.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery Mayo Clinic 200 First St SW 55905 Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin D.","family":"Zielinski","sequence":"additional","affiliation":[{"name":"Department of Surgery Mayo Clinic 200 First St SW 55905 Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald","family":"Jenkins","sequence":"additional","affiliation":[{"name":"Department of Surgery Mayo Clinic 200 First St SW 55905 Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry J.","family":"Schiller","sequence":"additional","affiliation":[{"name":"Department of Surgery Mayo Clinic 200 First St SW 55905 Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,11,18]]},"reference":[{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1010\u20107940(03)00256\u20102"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2005.07.022"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thorsurg.2010.07.004"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e31827019fd"},{"key":"e_1_2_8_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00068\u2010010\u20100046\u20105"},{"key":"e_1_2_8_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2012.12.024"},{"key":"e_1_2_8_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3182895bb0"},{"key":"e_1_2_8_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/000313481007600820"},{"key":"e_1_2_8_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/000313481408000622"},{"key":"e_1_2_8_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00068\u2010010\u20100048\u20103"},{"key":"e_1_2_8_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e31823c85e9"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-014-2862-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-014-2862-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-014-2862-y","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-014-2862-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T23:21:18Z","timestamp":1703632878000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-014-2862-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,11,18]]},"references-count":11,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2015,3]]}},"alternative-id":["10.1007\/s00268-014-2862-y"],"URL":"https:\/\/doi.org\/10.1007\/s00268-014-2862-y","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,11,18]]},"assertion":[{"value":"18 November 2014","order":1,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}