Surgical rib fixation as an alternative method of treatment for multiple rib fractures: an audit of results compared with traditional medical management

BACKGROUND: Rib fractures are a common cause of morbidity and chronic pain, delaying return to normal activities. Reports suggest that surgical fixation improves acute and long-term outcomesMETHOD: A single centre retrospective review of multiple rib fractures, comparing the outcomes of cases managed using surgical fixation with cases managed only with best medical therapy (BMT) over 2 yearsRESULTS: Thirty-five patients with rib fractures were admitted over the study period. The most common causes of rib fractures were motorcycle crashes (34.2%) and falls (31.4%). Fourteen patients had surgery. There were no differences between the two groups regarding the number of fractured ribs, injury severity score (ISS), ICU or hospital length of stay. The median numeric pain visual analogue scale (VAS) on admission was eight points for non-ventilated patients. In the surgical group the median VAS significantly fell to a median of 2 points in the first 24 hours after surgery (p = 0.04). Only two out of 25 major complications were directly attributable to the surgery for rib fixation. Patients managed without surgery needed significantly longer time to return to normal activities compared to those who had surgery (median 7 weeks versus 3 weeks, p = 0.03CONCLUSIONS: Our preliminary results suggest that rib fixation should be considered a treatment alternative in patients with multiple rib fractures

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Main Authors: Monzón,BI, Fingleson,LM, Moeng,MS
Format: Digital revista
Language:English
Published: Association of Surgeons of South Africa 2021
Online Access:http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0038-23612021000300007
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spelling oai:scielo:S0038-236120210003000072022-01-27Surgical rib fixation as an alternative method of treatment for multiple rib fractures: an audit of results compared with traditional medical managementMonzón,BIFingleson,LMMoeng,MS rib fractures surgical fixation flail chest trauma BACKGROUND: Rib fractures are a common cause of morbidity and chronic pain, delaying return to normal activities. Reports suggest that surgical fixation improves acute and long-term outcomesMETHOD: A single centre retrospective review of multiple rib fractures, comparing the outcomes of cases managed using surgical fixation with cases managed only with best medical therapy (BMT) over 2 yearsRESULTS: Thirty-five patients with rib fractures were admitted over the study period. The most common causes of rib fractures were motorcycle crashes (34.2%) and falls (31.4%). Fourteen patients had surgery. There were no differences between the two groups regarding the number of fractured ribs, injury severity score (ISS), ICU or hospital length of stay. The median numeric pain visual analogue scale (VAS) on admission was eight points for non-ventilated patients. In the surgical group the median VAS significantly fell to a median of 2 points in the first 24 hours after surgery (p = 0.04). Only two out of 25 major complications were directly attributable to the surgery for rib fixation. Patients managed without surgery needed significantly longer time to return to normal activities compared to those who had surgery (median 7 weeks versus 3 weeks, p = 0.03CONCLUSIONS: Our preliminary results suggest that rib fixation should be considered a treatment alternative in patients with multiple rib fracturesAssociation of Surgeons of South AfricaSouth African Journal of Surgery v.59 n.3 20212021-09-01journal articletext/htmlhttp://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0038-23612021000300007en
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country Sudáfrica
countrycode ZA
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databasecode rev-scielo-za
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region África del Sur
libraryname SciELO
language English
format Digital
author Monzón,BI
Fingleson,LM
Moeng,MS
spellingShingle Monzón,BI
Fingleson,LM
Moeng,MS
Surgical rib fixation as an alternative method of treatment for multiple rib fractures: an audit of results compared with traditional medical management
author_facet Monzón,BI
Fingleson,LM
Moeng,MS
author_sort Monzón,BI
title Surgical rib fixation as an alternative method of treatment for multiple rib fractures: an audit of results compared with traditional medical management
title_short Surgical rib fixation as an alternative method of treatment for multiple rib fractures: an audit of results compared with traditional medical management
title_full Surgical rib fixation as an alternative method of treatment for multiple rib fractures: an audit of results compared with traditional medical management
title_fullStr Surgical rib fixation as an alternative method of treatment for multiple rib fractures: an audit of results compared with traditional medical management
title_full_unstemmed Surgical rib fixation as an alternative method of treatment for multiple rib fractures: an audit of results compared with traditional medical management
title_sort surgical rib fixation as an alternative method of treatment for multiple rib fractures: an audit of results compared with traditional medical management
description BACKGROUND: Rib fractures are a common cause of morbidity and chronic pain, delaying return to normal activities. Reports suggest that surgical fixation improves acute and long-term outcomesMETHOD: A single centre retrospective review of multiple rib fractures, comparing the outcomes of cases managed using surgical fixation with cases managed only with best medical therapy (BMT) over 2 yearsRESULTS: Thirty-five patients with rib fractures were admitted over the study period. The most common causes of rib fractures were motorcycle crashes (34.2%) and falls (31.4%). Fourteen patients had surgery. There were no differences between the two groups regarding the number of fractured ribs, injury severity score (ISS), ICU or hospital length of stay. The median numeric pain visual analogue scale (VAS) on admission was eight points for non-ventilated patients. In the surgical group the median VAS significantly fell to a median of 2 points in the first 24 hours after surgery (p = 0.04). Only two out of 25 major complications were directly attributable to the surgery for rib fixation. Patients managed without surgery needed significantly longer time to return to normal activities compared to those who had surgery (median 7 weeks versus 3 weeks, p = 0.03CONCLUSIONS: Our preliminary results suggest that rib fixation should be considered a treatment alternative in patients with multiple rib fractures
publisher Association of Surgeons of South Africa
publishDate 2021
url http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0038-23612021000300007
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