Abstract
This report presents a case of multiple rib fractures in a patient with long-term use of corticosteroids for Wegener’s granulomatosis. A 49-year-old male was transported to the emergency room (ER) with thoracic injuries and hemorrhagic shock. He had a history of using corticosteroids. Oral intubation and chest drainage were performed at the ER, followed by intra-vascular embolization for a ruptured spleen. Internal fixation for multiple rib fractures using positive pressure ventilation was initiated in the ICU; however, it was extremely difficult to wean the patient from the mechanical ventilator. Thoracic regional anesthesia was introduced for pain management. However, it was impossible to wean the patient from mechanical ventilation. Surgical stabilization of the multiple rib fractures was performed on the 15th day after admission. The postoperative course was uneventful, and the patient was successfully weaned from the ventilator. The patient discharged on the 60th hospital day. Early surgical stabilization for multiple rib fractures should be considered based on the patient’s condition. This is especially true in compromised patients, such as the elderly and those with a long history of using corticosteroids, as well as for the patients for whom fixation is considered to be difficult to achieve by innerfixation.
