{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:44:42Z","timestamp":1777448682495,"version":"3.51.4"},"reference-count":18,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T00:00:00Z","timestamp":1697587200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"NIH T32 Training Grant in Critical Care","award":["NIGMS (5T32GM095442-11)"],"award-info":[{"award-number":["NIGMS (5T32GM095442-11)"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The anterior stove-in chest (ASIC) is a rare form of flail chest involving bilateral rib or sternal fractures resulting in an unstable chest wall that caves into the thoracic cavity. Given ASIC has only been described in a handful of case reports, this study sought to review our institution\u2019s experience in the surgical management of ASIC injuries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review of patients with ASIC was conducted at our level I trauma center from 1\/\/2021 to 3\/\/2023. Information pertaining to patient demographics, fracture pattern, operative management, and outcomes was obtained and compared across patients in the case series.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>6 patients met inclusion criteria, all males aged 37-78\u00a0years. 5 suffered motor vehicle collisions, and 1 was a pedestrian struck by an automobile. The median injury severity score was 28. All received ORIF within 5\u00a0days of admission, most commonly for ongoing respiratory distress. Patients 2 and 4 underwent bilateral ORIF of the ribs and sternum while patients 1, 5, and 6 underwent left-sided repair. Patient 3 required ORIF of left ribs and the sternum to stabilize their injuries. 5 of 6 patients were liberated from the ventilator and survived to discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study demonstrates successful operative management of 6 patients with ASIC and suggests that early operative intervention with ORIF for affected segments may improve respiratory mechanics, ability to wean from the ventilator, and overall survival. Further research is needed to generate standardized guidelines for the management of this uncommon and complex thoracic injury.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348231209530","type":"journal-article","created":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T02:11:04Z","timestamp":1697681464000},"page":"695-702","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Is Traumatic Anterior Stove-In Chest Truly so Rare? A Single Institution Experience"],"prefix":"10.1177","volume":"90","author":[{"given":"Courtney H.","family":"Meyer","sequence":"first","affiliation":[{"name":"Emory University School of Medicine, Atlanta, GA, USA"},{"name":"Grady Health System, Atlanta, GA, USA"},{"name":"Rollins School of Public Health, Emory University, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eunice","family":"Aworanti","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adora","family":"Santos","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine, Atlanta, GA, USA"},{"name":"Grady Health System, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Castater","sequence":"additional","affiliation":[{"name":"Grady Health System, Atlanta, GA, USA"},{"name":"Morehouse School of Medicine, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary M.","family":"Bauman","sequence":"additional","affiliation":[{"name":"University of Nebraska Medical Center, Omaha, NE, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krystal","family":"Archer-Arroyo","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine, Atlanta, GA, USA"},{"name":"Grady Health System, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Richard","family":"Sola","sequence":"additional","affiliation":[{"name":"Wellstar Medical Center, Marietta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7275-4088","authenticated-orcid":false,"given":"April","family":"Grant","sequence":"additional","affiliation":[{"name":"Saint Alphonsus, Boise, ID, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Randi N.","family":"Smith","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine, Atlanta, GA, USA"},{"name":"Grady Health System, Atlanta, GA, USA"},{"name":"Rollins School of Public Health, Emory University, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason D.","family":"Sciarretta","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine, Atlanta, GA, USA"},{"name":"Grady Health System, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan H.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Grady Health System, Atlanta, GA, USA"},{"name":"Morehouse School of Medicine, Atlanta, GA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,10,18]]},"reference":[{"key":"bibr1-00031348231209530","volume-title":"AAST _ Trauma Facts","author":"AAST","year":"2020"},{"key":"bibr2-00031348231209530","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijso.2021.100420"},{"key":"bibr3-00031348231209530","volume-title":"Flail chest - 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