{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:47:25Z","timestamp":1787755645980,"version":"build-2784847793"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>We present a complex case of a 56-year-old man with multiple left-sided rib pathology including nonunion, rib heterotopic ossification (HO) forming a rib-to-rib synostosis, and rib malunion. After a major forequarter trauma and failed conservative management, followed by scapula reconstruction and rib recontouring, the surgical resection of the rib synostosis, reconstruction of a rib nonunion, and contouring of rib malunions are described. The patient was followed up clinically for 1 year after the final procedure and demonstrated marked improvement in functional outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In the setting of complex forequarter malunion and nonunion, resolution of painful rib nonunion and synostosis can be effectively managed with HO resection and rib reconstruction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.19.00368","type":"journal-article","created":{"date-parts":[[2020,7,10]],"date-time":"2020-07-10T11:00:44Z","timestamp":1594378844000},"page":"e19.00368-e19.00368","source":"Crossref","is-referenced-by-count":8,"title":["Operative Management of Rib Synostosis and Malunion"],"prefix":"10.2106","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5560-7796","authenticated-orcid":false,"given":"Erick M.","family":"Marigi","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Minnesota Medical School, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5441-9112","authenticated-orcid":false,"given":"Anthony J.","family":"Dugarte","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Minnesota Medical School, Minneapolis, Minnesota"},{"name":"Department of Orthopaedic Surgery, Regions Hospital, St. Paul, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6217-5103","authenticated-orcid":false,"given":"Peter. A","family":"Cole","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Minnesota Medical School, Minneapolis, Minnesota"},{"name":"Department of Orthopaedic Surgery, Regions Hospital, St. Paul, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020]]},"reference":[{"issue":"6","key":"bib1-20230720","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1097\/BOT.0000000000000254","article-title":"Outcomes after operative management of symptomatic rib nonunion","volume":"29","author":"Gauger","year":"2015","journal-title":"J Orthop Trauma."},{"issue":"1","key":"bib2-20230720","doi-asserted-by":"crossref","first-page":"97","DOI":"10.2106\/JBJS.I.00696","article-title":"Operative treatment of chest wall injuries: indications, technique, and outcomes","volume":"93","author":"Lafferty","year":"2011","journal-title":"J Bone Joint Surg Am."},{"issue":"2","key":"bib3-20230720","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.injury.2016.11.026","article-title":"Consensus statement: surgical stabilization of rib fractures rib fracture colloquium clinical practice guidelines","volume":"48","author":"Pieracci","year":"2017","journal-title":"Injury."},{"issue":"4","key":"bib4-20230720","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.1016\/j.athoracsur.2015.06.046","article-title":"Thoracoscopic resection of a symptomatic, congenital rib synostosis","volume":"101","author":"Brewer","year":"2016","journal-title":"Ann Thorac Surg."},{"issue":"2","key":"bib5-20230720","doi-asserted-by":"crossref","first-page":"e143","DOI":"10.1016\/j.athoracsur.2016.07.061","article-title":"Surgical treatment of snapping scapula syndrome due to malunion of rib fractures","volume":"103","author":"ten Duis","year":"2017","journal-title":"Ann Thorac Surg."},{"issue":"1","key":"bib6-20230720","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/S1058-2746(03)00055-7","article-title":"Snapping scapula syndrome due to malunion of rib fractures: a case report","volume":"13","author":"Takahara","year":"2004","journal-title":"J Shoulder Elbow Surg."},{"issue":"1","key":"bib7-20230720","doi-asserted-by":"crossref","first-page":"e000347","DOI":"10.1136\/tsaco-2019-000347","article-title":"Chronic pain associated with costal margin rupture","volume":"4","author":"Kaufman","year":"2019","journal-title":"Trauma Surg Acute Care Open."},{"issue":"19","key":"bib8-20230720","doi-asserted-by":"crossref","first-page":"1623","DOI":"10.2106\/JBJS.15.01224","article-title":"Functional outcomes after operative management of extra-articular glenoid neck and scapular body fractures","volume":"98","author":"Schroder","year":"2016","journal-title":"J Bone Joint Surg Am."},{"key":"bib9-20230720","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1002\/(SICI)1097-0274(199606)29:6<602::AID-AJIM4>3.0.CO;2-L","article-title":"Development of an upper extremity out- come measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG)","volume":"29","author":"Hudak","year":"1996","journal-title":"Am J Ind Med."},{"issue":"3","key":"bib10-20230720","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1097\/TA.0000000000001350","article-title":"Operative fixation of rib fractures after blunt trauma: a practice management guideline from the Eastern Association for the Surgery of Trauma","volume":"82","author":"Kasotakis","year":"2017","journal-title":"J Trauma Acute Care Surg."},{"issue":"6","key":"bib11-20230720","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1177\/000313481408000622","article-title":"Prospective clinical trial of surgical intervention for painful rib fracture nonunion","volume":"80","author":"Fabricant","year":"2014","journal-title":"Am Surg."},{"issue":"1","key":"bib12-20230720","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.injury.2014.06.014","article-title":"Quality of life after major trauma with multiple rib fractures","volume":"46","author":"Marasco","year":"2015","journal-title":"Injury."},{"issue":"12","key":"bib13-20230720","doi-asserted-by":"crossref","first-page":"2444","DOI":"10.1016\/j.jhsa.2014.08.034","article-title":"Thoracic outlet syndrome caused by synostosis of the first and second thoracic ribs: 2 case reports and review of the literature","volume":"39","author":"Reidler","year":"2014","journal-title":"J Hand Surg Am."}],"container-title":["JBJS Case Connector"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.19.00368","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:46:46Z","timestamp":1787752006000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.19.00368"}},"subtitle":["A Case Report"],"short-title":[],"issued":{"date-parts":[[2020]]},"references-count":13,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.cc.19.00368","relation":{},"ISSN":["2160-3251"],"issn-type":[{"value":"2160-3251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020]]}}}