Operative fixation of rib fracture nonunions

DeGenova, Daniel T; Miller, Klay B; McClure, Tanner T; Schuette, Hayden B.; French, Bruce; Taylor, Benjamin C.

doi:10.1007/s00402-022-04540-z

Cited by 6 publications

(9 citation statements)

References 34 publications

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“…21 Weaknesses of this study included potential for recall bias, its retrospective natures, and the absence of objective measures of pain, opioid usage and patient reported outcomes. Also in 2022, DeGenova et al 22 published a retrospective, single-institution, cohort study of 18 patients SSNURF. All patients reported improvement in their pain after surgical intervention although objective comparisons were not performed.…”

Section: Resultsmentioning

confidence: 99%

Chest Wall Injury Society recommendation for surgical stabilization of nonunited rib fractures to decrease pain, reduce opiate use, and improve patient reported outcomes in patients with rib fracture nonunion after trauma

Forrester,

Bauman,

Cole

et al. 2023

J Trauma Acute Care Surg

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Background Rib fractures are common injuries which can be associated with acute pain and chronic disability. While most rib fractures ultimately go on to achieve bony union, a subset of patients may go on to develop non-union. Management of these non-united rib fractures can be challenging and variability in management exists. Methods The Chest Wall Injury Society’s Publication Committee convened to develop recommendations for use of surgical stabilization of non-united rib fractures (SSNURF) to treat traumatic rib fracture non-unions. PubMed, Embase, and the Cochrane database were searched for pertinent studies. Using a process of iterative consensus, all committee members voted to accept or reject the recommendation. Results No identified studies compared SSNURF to alternative therapy and the overall quality of the body of evidence was rated as low. Risk of bias was identified in all studies. Despite these limitations, there is lower quality evidence suggesting SSNURF may be beneficial for decreasing pain, reducing opiate use, and improving patient reported outcomes among patients with symptomatic rib non-union. However, these benefits should be balanced against risk of symptomatic hardware failure and infection. Conclusions This guideline document summarizes the current CWIS recommendations regarding use of SSNURF for management of rib non-union. Level of Evidence Level IV, therapeutic/care management

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Section: Resultsmentioning

confidence: 99%

Chest Wall Injury Society recommendation for surgical stabilization of nonunited rib fractures to decrease pain, reduce opiate use, and improve patient reported outcomes in patients with rib fracture nonunion after trauma

Forrester,

Bauman,

Cole

et al. 2023

J Trauma Acute Care Surg

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“…This population may relate closely to our series as these patients are less acute and can be optimized for surgery. Traditionally, patients who undergo rib ORIF for symptomatic nonunion have spent at least one night in the hospital for observation [ 4 , 19 ]. DeGenova et al recently published a series of 18 patients who underwent ORIF for rib fracture nonunion and the average hospital length of stay was three days [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Traditionally, patients who undergo rib ORIF for symptomatic nonunion have spent at least one night in the hospital for observation [ 4 , 19 ]. DeGenova et al recently published a series of 18 patients who underwent ORIF for rib fracture nonunion and the average hospital length of stay was three days [ 4 ]. Another series reported on 10 patients undergoing ORIF for rib fracture nonunion, where 40% of patients required chest tube insertion for lung parenchymal injury [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…Most rib fractures are treated nonoperatively, with nearly 80% of patients with multiple rib fractures showing evidence of healing based on computed tomography scans at three months post-injury [ 2 , 3 ]. Infrequently, non-operative management fails and leads to continued intractable pain [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…A recent systemic review demonstrated operative fixation of rib fractures led to a signiﬁcant decrease in pneumonia, a decrease in mortality, and a decrease in hospital length of stay [ 6 ]. Surgical intervention for rib fractures has historically been associated with multiple days of hospital admission for observation after surgery [ 4 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Outpatient Surgery for Rib Fracture Fixation: A Report of Three Cases

DeGenova¹,

Schmitz²,

Lin³

et al. 2022

Cureus

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Rib fractures are common injuries observed in trauma patients that will often heal without operative intervention. However, patients can infrequently have continued pain. Operative fixation of these symptomatic rib fractures has traditionally led to the patient requiring hospital admission for observation and pain control. The purpose of this study was to review three cases of outpatient rib fracture, open reduction and internal fixation (ORIF) surgery. Three patients with symptomatic rib fractures treated with ORIF at a single urban level one trauma center underwent outpatient same-day surgery. Pertinent demographic, clinical, radiographic, and surgical data were collected. All patients had decreased preoperative pain and no complications. This case series demonstrates that outpatient surgery for rib fracture ORIF can be performed safely in a select patient population. Additionally, it has similar efficacy as inpatient operative fixation with the main added benefit being decreased costs to both the patient and the healthcare system. We suggest that outpatient operative fixation of rib fractures should be considered for select patients.

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