Postoperative submuscular emphysema due to air leakage from the residual screw holes after plate removal in a patient who had undergone surgical stabilization of flail chest

Many studies have reported indications and complications of surgical stabilization of rib fractures. However, data about the postoperative complications after the removal of the plates are still lacking. The author reports a rare complication after plate removal, postoperative submuscular emphysema, due to air leakage from the residual screw hole. A 68-year-old male with a flail chest was successfully treated by surgical rib fixation. A few months later, the patient wanted his implants removed due to chest irritation. The removal operation was completed, and postoperative courses were not unusual. However, a large amount of submuscular emphysema was found in the follow-up period. The patient was successfully managed by applying a submuscular thoracic drainage catheter. Although postoperative subcutaneous emphysema due to residual screw holes after plate removal is rare, we need to pay more attention when selecting the proper length of screws during surgical rib fixation.