{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T15:57:49Z","timestamp":1785254269096,"version":"3.55.0"},"reference-count":13,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,12,15]],"date-time":"2024-12-15T00:00:00Z","timestamp":1734220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Rib fractures are common in patients with trauma, and patients with multiple rib fractures often require surgical stabilization. Because rib fractures may occur at different sites along the ribs, the technical approach to surgical stabilization varies. Here, we present a case of posterior rib fractures with multiple paraspinal fragmented rib segments that were successfully treated with costovertebral plate fixation. Case Presentation: A truck driver was injured after falling from the top of a truck. Computed tomography scans of the chest showed multiple flail segments along the paraspinal and posterolateral regions with a clinically evident flail chest. Owing to the proximity of the flail segments to the thoracic spine, rib plating was performed across the ribs and the transverse processes of the thoracic spine with the assistance of a neurosurgeon. The patient was extubated on postoperative day 1 and discharged successfully after the other traumatic injuries were treated. Discussion: Far posterior rib fractures close to the spine may be challenging, particularly if plates for rib fractures cannot be placed on the ribs alone. For such challenges, costotransverse plating is a feasible surgical option. However, the anatomical orientation of the rib and the transverse process of the thoracic spine are different, which complicates surgical planning and maneuvers. Therefore, a thorough understanding of the costotransverse anatomy is critical for successful surgical stabilization of fractured ribs. Conclusions: This is a good example of a challenging case of rib fractures requiring paraspinal plate stabilization.<\/jats:p>","DOI":"10.3390\/medicina60122063","type":"journal-article","created":{"date-parts":[[2024,12,16]],"date-time":"2024-12-16T06:48:39Z","timestamp":1734331719000},"page":"2063","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comminuted Paraspinal Rib Fractures with Resultant Impending Penetrating Aortic Injury Requiring Costovertebral Rib Fixation: A Case Report"],"prefix":"10.3390","volume":"60","author":[{"given":"Soon-Ki","family":"Min","sequence":"first","affiliation":[{"name":"Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon 21565, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae-Seok","family":"Jeong","sequence":"additional","affiliation":[{"name":"Department of Traumatology, Gachon University College of Medicine, Incheon 21565, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang-Bin","family":"Jeon","sequence":"additional","affiliation":[{"name":"Department of Traumatology, Gachon University College of Medicine, Incheon 21565, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e000059","DOI":"10.1136\/tsaco-2016-000059","article-title":"Rib fixation: Who, What, When?","volume":"2","author":"Nirula","year":"2017","journal-title":"Trauma Surg. Acute Care Open"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1016\/j.injury.2020.12.021","article-title":"Far posterior rib plating: Preliminary results of a retrospective case series","volume":"52","author":"Schuette","year":"2021","journal-title":"Injury"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1186\/s13019-023-02203-7","article-title":"The effectiveness of early surgical stabilization for multiple rib fractures: A multicenter randomized controlled trial","volume":"18","author":"Wang","year":"2023","journal-title":"J. Cardiothorac. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1007\/s00068-010-0046-5","article-title":"Historic overview of treatment techniques for rib fractures and flail chest","volume":"36","author":"Bemelman","year":"2010","journal-title":"Eur. J. Trauma Emerg. 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Neurol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/12\/2063\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:52:41Z","timestamp":1760115161000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/12\/2063"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,15]]},"references-count":13,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["medicina60122063"],"URL":"https:\/\/doi.org\/10.3390\/medicina60122063","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,15]]}}}