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Improved chest wall trauma taxonomy: an interdisciplinary CWIS and ASER collaboration

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Abstract

Purpose

Chest wall injury taxonomy and nomenclature are important components of chest wall injury classification and can be helpful in communicating between providers for treatment planning. Despite the common nature of these injuries, there remains a lack of consensus regarding injury description. The Chest Wall Injury Society (CWIS) developed a taxonomy among surgeons in the field; however, it lacked consensus and clarity in critical areas and collaboration with multidisciplinary partners. We believe an interdisciplinary collaboration between CWIS and American Society of Emergency Radiology (ASER) will improve existing chest wall injury nomenclature and help further research on this topic.

Methods

A collaboration between CWIS and ASER gathered feedback on the consensus recommendations. The workgroup held a series of meetings reviewing each consensus statement, refining the terminology, and contributing additional clarifications from a multidisciplinary lens.

Results

After identifying incomplete definitions in the CWIS survey, the workgroup expanded on and clarified the language proposed by the survey. More precise definitions related to rib and costal cartilage fracture quality and location were developed. Proposed changes include more accurate characterization of rib fracture displacement and consistent description of costal cartilage fractures.

Conclusions

The 2019 consensus survey from CWIS provides a framework to discuss chest wall injuries, but several concepts remained unclear. Creating a universally accepted taxonomy and nomenclature, utilizing the CWIS survey and this article as a scaffolding, may help providers communicate the severity of chest wall injury accurately, allow for better operative planning, and provide a common language for researchers in the future.

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Author information

Authors and Affiliations

  1. Department of Surgery, Morehouse School of Medicine, Atlanta, GA, USA

    Jonathan Nguyen

  2. Department of Radiology, Emory University School of Medicine, Atlanta, GA, USA

    Krystal Archer-Arroyo

  3. Department of Radiology, University of Washington, Seattle, WA, USA

    Joel A. Gross

  4. Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA

    Scott D. Steenburg

  5. Department of Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

    Clint W. Sliker

  6. Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA

    Courtney H. Meyer

  7. Department of Radiology, Helsinki University Hospital, Helsinki, Finland

    Mari T. Nummela

  8. Department of Surgery, University of Colorado School of Medicine, Denver, CO, USA

    Fredric M. Pieracci

  9. Department of Surgery, Overland Park Regional Medical Center, Overland Park, KS, USA

    Adam J. Kaye

Authors
  1. Jonathan Nguyen
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  2. Krystal Archer-Arroyo
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  3. Joel A. Gross
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  4. Scott D. Steenburg
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  5. Clint W. Sliker
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  6. Courtney H. Meyer
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  7. Mari T. Nummela
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  8. Fredric M. Pieracci
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  9. Adam J. Kaye
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Contributions

FP, AK, JG, and SS conceived the study and its design. JG, SS, CS, and KAA performed a literature search. SS coordinated the workgroup meetings. All authors participated in the workgroup. JG, JN, and KAA created the draft version of the manuscript. CM assisted in revisions of the manuscript, imaging, and tables. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jonathan Nguyen.

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Conflict of interest

Dr. Jonathan Nguyen receives honoraria for educational courses from Biomet, Pry-time Medical, and Teleflex. Dr. Scott D. Steenburg receives research grant support from the US Department of the Army. For the remaining authors, no conflicts were declared.

Dr. Adam J. Kaye is an educator/consultant for Zimmer/Biomet and Atricure.

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This study was presented at the 6th annual meeting of the Chest Wall Injury Society, April 29, 2022, in Park City, UT.

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Nguyen, J., Archer-Arroyo, K., Gross, J.A. et al. Improved chest wall trauma taxonomy: an interdisciplinary CWIS and ASER collaboration. Emerg Radiol 30, 637–645 (2023). https://doi.org/10.1007/s10140-023-02171-4

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  • DOI: https://doi.org/10.1007/s10140-023-02171-4

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