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<p>Severe thoracic trauma is among the most frequent and potentially lethal injuries in severely injured patients. Almost 50% of polytrauma patients present with relevant chest trauma (AIS ≥ 3). The spectrum ranges from chest wall instability and pulmonary contusions to life‑threatening injuries of the heart, great vessels, and tracheobronchial tree. While initial ATLS-based management is well established, treatment strategies for severe chest wall injuries have shifted in recent years from predominantly non-operative care towards early surgical stabilization. This paradigm change is driven by growing evidence that rapid restoration of chest wall integrity and biomechanics significantly reduces morbidity (e.g. pneumonia, ventilation time, ICU stay) and mortality. This CME article summarises current diagnostics and therapy, outlines indications and contraindications for operative interventions, and reviews complication management in severe thoracic trauma management.</p>

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Das schwere Thoraxtrauma

  • 期刊论文

  • 发表日期：

    2026年5月7日

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  • Christopher Spering,
  • Thorsten Walles,
  • Hassan Awan Malik,
  • Alexander von Hammerstein-Equort,
  • Wolfgang Lehmann

摘要

Severe thoracic trauma is among the most frequent and potentially lethal injuries in severely injured patients. Almost 50% of polytrauma patients present with relevant chest trauma (AIS ≥ 3). The spectrum ranges from chest wall instability and pulmonary contusions to life‑threatening injuries of the heart, great vessels, and tracheobronchial tree. While initial ATLS-based management is well established, treatment strategies for severe chest wall injuries have shifted in recent years from predominantly non-operative care towards early surgical stabilization. This paradigm change is driven by growing evidence that rapid restoration of chest wall integrity and biomechanics significantly reduces morbidity (e.g. pneumonia, ventilation time, ICU stay) and mortality. This CME article summarises current diagnostics and therapy, outlines indications and contraindications for operative interventions, and reviews complication management in severe thoracic trauma management.