Chest Wall Reconstruction of an Infected Open Costal Arch Fracture.

A 55-year-old man presented with sepsis, 2 weeks after blunt chest trauma, with an open costal arch fracture. Imaging showed an extensive chest wall soft tissue infection. After resuscitation, soft tissue debridement was performed, and broad-spectrum antibiotics were started. Multiple debridements of the soft tissue were required in addition to allograft skin grafting. Once the soft tissue infection was under control, the costal arch fracture involving the costal cartilages was debrided. Chest wall reconstruction was performed successfully with bioabsorbable bars, an omental flap, and skin grafting. Long-term follow-up showed excellent viable tissue and no flail chest.