The ideal methods for the management of rib fractures

He, Zhe; Zhang, Dongsheng; Xiao, Haiping; Xuan, Yiwen; Su, Kai; Liao, Ming; Tang, Yong; Xu, Enwu

doi:10.21037/jtd.2019.04.109

Cited by 47 publications

(41 citation statements)

References 46 publications

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“…In addition, in some studies for rib fracture cases, it is recommended that the cases should be operated within 24 to 72 h. However, these results are not based on any statistical analysis, but are based on the personal opinions of the authors. [14] In the present study, we found no statistically significant difference in the rate of pneumonia and septic complications between the patient groups. We consider that stabilization of the thoracic wall and the paradoxical chest movement correction in the surgical group may have positively affected the thoracic compliance.…”

Section: Discussioncontrasting

confidence: 56%

The benefits of early rib fixation for clinical outcomes of flail chest patients in intensive care unit

Ağababaoğlu

Ersöz

2020

Turk Gogus Kalp Dama

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Bu çalışmada yelken göğüs hastalarında konservatif ve cerrahi stabilizasyon yaklaşımlarının klinik sonuçları karşılaştırıldı ve erken redüksiyonun etkisi araştırıldı. Ça lış m a pla nı: Mart 2013-Aralık 2017 tarihleri arasında erken kaburga fiksasyonu yapılan yelken göğüslü 34 hasta (23 erkek, 11 kadın; ort. yaş 43.7±12.1 yıl; dağılım 20-74 yıl) cerrahi grubuna ve Şubat 2012-Aralık 2017 tarihleri arasında konservatif yaklaşım ile takip edilen yelken göğüslü 29 hasta (19 erkek, 10 kadın; ort. yaş 45.7±15.8 yıl; dağılım 24-74 yıl) konservatif tedavi grubuna alındı. Travmanın olduğu gün veya bir sonraki gün (24 ila 36 saat içerisinde) erken kaburga redüksiyonu uygulandı. Hastanede kalış süresi, ameliyat sonrası dönemde pnömoni ve septik komplikasyon varlığı, mortalite, mekanik ventilasyon süresi, trakeostomi oranı, solunum fonksiyon test sonuçları ve ağrı skorları kaydedildi ve gruplar arasında karşılaştırıldı. Bul gu lar: Hastanede ve yoğun bakım ünitesinde yatış süresi ve mekanik ventilasyon süresi cerrahi grubuna kıyasla, konservatif tedavi grubunda istatistiksel olarak anlamlı düzeyde daha uzun idi (sırasıyla p<0.001, p<0.001 ve p<0.001). Cerrahi grupta hiçbir hastada trakeostomi gerekmez iken, konservatif tedavi grubunda beş hastada trakeostomi gereksinimi oldu (p= 0.004). Mortalite oranları cerrahi ve konservatif tedavi gruplarında sırasıyla %2.94 ve %20.69 idi (p= 0.027). Ağrı skorları, konservatif tedavi grubuna kıyasla, cerrahi grup lehine istatistiksel olarak anlamlı düzeyde farklı idi (sırasıyla p= 0.0038 ve p= 0.044). So nuç:Çalışmamızın sonuçları erken fiksasyon ve erken ekstübasyonun mekanik ventilasyon gereksinimini, hastanede yatış süresini, trakeostomi ihtiyacını ve ölüm oranlarını azalttığını göstermektedir. Bu yaklaşım, yelken göğüs hastalarında uzun dönem ağrı şikayetinde ve solunum fonksiyon testlerinde önemli bir iyileşme sağlar. Anah tarsöz cük ler: Yelken göğüs, kilitli kaburga plağı, kaburga kırığı, toraks travması.

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Section: Discussioncontrasting

confidence: 56%

The benefits of early rib fixation for clinical outcomes of flail chest patients in intensive care unit

Ağababaoğlu

Ersöz

2020

Turk Gogus Kalp Dama

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“…In the United Kingdom, orthopaedic surgeons undertake rib stabilisation. There have been studies (6) that have suggested that a combination of multiple rib fractures and underlying pulmonary contusions would be a contraindication for operative intervention. There also suggestions that patients with severe pulmonary contusions would not be suitable candidates for surgical xation.…”

Section: Optimal Management Of Rib Fracturesmentioning

confidence: 99%

Management of multiple rib fractures-results from a Major Trauma Centre with review of the existing literature

Chowdhury

Okoh

Dambappa

2020

Preprint

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Introduction Rib fractures are amongst the most common fractures following major trauma presenting to the Emergency Department. It accounts for more than 15% of ED presentations (1) on a global scale. As the population ages the incidence of rib fractures also rises often following falls from a relatively small height being part of fragility fractures. The impact of rib fractures is even more significant in the patient with underlying chronic respiratory conditions.Aim To assess our current management of rib fractures at our trauma centreMethod We collected our data from the TARN Registry primarily focussing on patients with multiple rib fractures. The main components were the analgesic requirement of our patients. We also studied the number of rib fracture stabilisation procedures and the average number of ribs fixed.Results The data was collected retrospectively over a period of 12 months. There were 313 patients identified as having chest wall injuries. From the data, 41.9% (131) of patients were over the age of 65 years. A significant proportion of our patients 34.5% (108) were noted to have multiple rib fractures (>3 Ribs). It was noted that 3% (9) of the 313 patients required operations. The average of the patients included in the study was noted to be 61 years with an age range of 17-92 years.Conclusion The mainstay management of rib fracture is provision of adequate analgesia and the prevention of respiratory complications that can all stem from poor ventilatory function amongst other patient factors and injury patterns. Through the decades, surgical stabilisation has gained pace and has found its niche in the management of rib fractures.

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“…In the United Kingdom, orthopaedic surgeons undertake rib stabilisation. There have been studies [6] that have suggested that a combination of multiple rib fractures and underlying pulmonary contusions would be a contraindication for operative intervention. There also suggestions that patients with severe pulmonary contusions would not be suitable candidates for surgical fixation.…”

Section: Optimal Management Of Rib Fracturesmentioning

confidence: 99%

Management of Multiple Rib Fractures-Results from a Major Trauma Centre with Review of the Existing Literature

Chowdhury¹,

Okoh²,

Dambappa³

2020

Int J Crit Care Emerg Med

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Introduction: Rib fractures are amongst the most common fractures following major trauma presenting to the Emergency Department. It accounts for more than 15% of ED presentations [1] on a global scale. As the population ages the incidence of rib fractures also rises often following falls from a relatively small height being part of fragility fractures. The impact of rib fractures is even more significant in the patient with underlying chronic respiratory conditions.Aim: To assess our current management of rib fractures at our trauma centre. Method:We collected our data from the TARN Registry primarily focussing on patients with multiple rib fractures. The main components were the analgesic requirement of our patients. We also studied the number of rib fracture stabilisation procedures and the average number of ribs fixed. Results:The data was collected retrospectively over a period of 12 months. There were 313 patients identified as having chest wall injuries. From the data, 41.9% (131) of patients were over the age of 65 years. A significant proportion of our patients 34.5% (108) were noted to have multiple rib fractures (> 3 Ribs). It was noted that 3% (9) of the 313 patients required operations. The average of the patients included in the study was noted to be 61 years with an age range of 17-92 years. Conclusion:The mainstay management of rib fracture is provision of adequate analgesia and the prevention of respiratory complications that can all stem from poor ventilatory function amongst other patient factors and injury patterns. Through the decades, surgical stabilisation has gained pace and has found its niche in the management of rib fractures.

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The ideal methods for the management of rib fractures

Cited by 47 publications

References 46 publications

The benefits of early rib fixation for clinical outcomes of flail chest patients in intensive care unit

The benefits of early rib fixation for clinical outcomes of flail chest patients in intensive care unit

Management of multiple rib fractures-results from a Major Trauma Centre with review of the existing literature

Management of Multiple Rib Fractures-Results from a Major Trauma Centre with Review of the Existing Literature

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