Early Surgical Stabilization of Flail Chest With Locked Plate Fixation

Althausen, Peter L.; Shannon, Steven F.; Watts, Chad D.; Thomas, Kenneth; Bain, Martin A; Coll, Daniel; O'Mara, Timothy J; Bray, Timothy J.

doi:10.1097/bot.0b013e318234d479

Cited by 121 publications

(90 citation statements)

References 30 publications

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“…What is more astounding, however, is how our outcomes compare with previously published outcomes in nonoperative patients. 6,[8][9][10][11][12][14][15][16][17][18][19][20] When compared with the RCT by Marasco and colleagues, days on a ventilator in our study were less than half of theirs, ICU LOS in our study was more than 11 days shorter, and hospital LOS was 9 days shorter, while their pneumonia rates were 3 times higher than ours. 10 Despite our retrospective matched cohort design, our study raises some interesting questions for future examination, especially considering that the only other North American study on this topic also found no significant improvements in LOS or ventilator days with flail chest fixation.…”

Section: Discussioncontrasting

confidence: 37%

No benefit to surgical fixation of flail chest injuries compared with modern comprehensive management: results of a retrospective cohort study

et al. 2016

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Section: Discussioncontrasting

confidence: 37%

No benefit to surgical fixation of flail chest injuries compared with modern comprehensive management: results of a retrospective cohort study

et al. 2016

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“…As compared to nonoperative treatment, patients undergoing rib fixation have been shown to have shorter intensive care unit stays, decreased ventilator requirements, shorter overall hospital length of stays, fewer tracheostomies, less pneumonia, less need for reintubation, and decreased home oxygen supplementation [1,6,8]. However, evidence-based treatment algorithms for rib fracture fixation are currently absent, as further large-scale randomized studies are needed to help further delineate true surgical indications.…”

Section: Discussionmentioning

confidence: 99%

“…Open reduction and internal fixation for rib fractures is an increasingly established treatment method for flail chest [1]. As compared to nonoperative treatment, patients undergoing rib fixation have been shown to have shorter intensive care unit stays, decreased ventilator requirements, shorter overall hospital length of stays, fewer tracheostomies, less pneumonia, less need for reintubation, and decreased home oxygen supplementation [1,6,8].…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of a Recalcitrant Pleural Effusion with Rib Fracture Fixation

Taylor

French

2012

HSS Jrnl

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Pulmonary complications of rib fractures typically occur in the immediate postinjury period, as a result of the forces causing the injury or subsequent rib fracture displacement. Pneumothorax, hemothorax, pulmonary contusions, or parenchymal lacerations are frequently seen with significant chest wall trauma. Hemopneumothorax is typically treated with tube thoracostomy, and full resolution of the pleural injury is expected; continued pleural fluid accumulation despite these measures is unanticipated, rare, and quite problematic. We report a case of hemorrhagic pleural effusion after rib fractures that were recurrent despite several tube thoracostomies and computed tomography-guided aspirations. The patient subsequently underwent operative fixation of her rib fractures, with successful resolution of her symptomatic pleural effusion.

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“…Different materials and methods involved in surgical fixation for fractured ribs have been reported [16,26,27]. But actually, reliable and effective materials and methods proved by clinical trials are still few.…”

Section: Discussionmentioning

confidence: 99%

Potential Benefits of Rib Fracture Fixation in Patients with Flail Chest and Multiple Non-flail Rib Fractures

et al. 2015

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The purpose of this study is to evaluate the potential benefits of rib fracture fixation in patients with flail chest and multiple non-flail rib fractures versus conventional treatment modalities. A retrospective reviewed study compared 86 cases which received surgical treatment between June 2009 and May 2013 to 76 cases which received conservative treatment between January 2006 and May 2009. The patients were divided into the flail chest (n=38) and multiple non-flail rib fracture groups (n=124). In the flail chest group, the mechanical ventilation time, ICU monitoring time, tracheostomies, thoracic deformity, and impaired pulmonary function and return to full-time employment were compared. In the multiple non-flail rib fracture group, fracture healing, visual analog scale (VAS) pain score, inpatient length of stay, atelectatic, pulmonary complications, and normal activity-returning time were compared. Patients in the flail chest operative fixation group had significantly shorter ICU stay, decreased ventilator requirements, fewer tracheostomies, less thoracic deformity and impaired pulmonary function, and more returned to fulltime employment. Patients in the multiple non-flail rib fracture operative fixation had shorter hospital stay, less pain, earlier return to normal activity, more fracture healing, less atelectasis, and fewer pulmonary infections. This study demonstrates the potential benefits of surgical stabilization of flail chest and multiple non-flail rib fractures with plate fixation. When compared with conventional conservative management, operatively managed patients demonstrated improved clinical outcomes.

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Early Surgical Stabilization of Flail Chest With Locked Plate Fixation

Cited by 121 publications

References 30 publications

No benefit to surgical fixation of flail chest injuries compared with modern comprehensive management: results of a retrospective cohort study

No benefit to surgical fixation of flail chest injuries compared with modern comprehensive management: results of a retrospective cohort study

Successful Treatment of a Recalcitrant Pleural Effusion with Rib Fracture Fixation

Potential Benefits of Rib Fracture Fixation in Patients with Flail Chest and Multiple Non-flail Rib Fractures

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