Rib fixation: Who, What, When?

Moya, Marc de; Nirula, Ram; Biffl, Walter L.

doi:10.1136/tsaco-2016-000059

“…Over the past decades, there has been increasing interest concerning different treatment strategies for rib fractures with a large number of studies reporting on the surgical treatment of these injuries [9,10]. However, little is known about the current incidence of rib fractures and how extensive the problem is among the trauma population.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and outcome of rib fractures: a nationwide study in the Netherlands

Peek

¹

,

Beks

²

,

Hietbrink

³

et al. 2020

Eur J Trauma Emerg Surg

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Purpose Rib fractures following thoracic trauma are frequently encountered injuries and associated with a significant morbidity and mortality. The aim of this study was to provide current data on the epidemiology, in-hospital outcomes and 30-day mortality of rib fractures, and to evaluate these results for different subgroups. Methods A nationwide retrospective cohort study was performed with the use of the Dutch Trauma Registry which covers 99% of the acutely admitted Dutch trauma population. All patients aged 18 years and older admitted to the hospital between January 2015 and December 2017 with one or more rib fractures were included. Incidence rates were calculated using demographic data from the Dutch Population Register. Subgroup analyses were performed for flail chest, polytrauma, primary thoracic trauma, and elderly patients. Results A total of 14,850 patients were admitted between 2015 and 2017 with one or more rib fractures, which was 6.0% of all trauma patients. Of these, 573 (3.9%) patients had a flail chest, 4438 (29.9%) were polytrauma patients, 9273 (63.4%) were patients with primary thoracic trauma, and 6663 (44.9%) were elderly patients. The incidence rate of patients with rib fractures for the entire cohort was 29 per 100.000 person-years. The overall 30-day mortality was 6.9% (n = 1208) with higher rates observed in flail chest (11.9%), polytrauma (14.8%), and elderly patients (11.7%). The median hospital length of stay was 6 days (IQR, 3-11) and 37.3% were admitted to the intensive care unit (ICU). Conclusions Rib fractures are a relevant and frequently occurring problem among the trauma population. Subgroup analyses showed that there is a substantial heterogeneity among patients with rib fractures with considerable differences regarding the epidemiology, in-hospital outcomes, and 30-day mortality.

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“…Indications for operative management (8) Recommended: Pain scores in isolation are not currently being considered (9) as an indication for operative intervention due to the subjectivity and the patient-to patient variability.…”

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

¹

,

Okoh

²

,

Dambappa

³

2020

Preprint

0

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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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“…Indications for operative management (8) bene t of the operative procedure in patients with less than 5 rib fractures remains to be seen. One of the main limitations that could be addressed in future studies would be to study the trends in operative management through the years.…”

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

¹

,

Okoh

²

,

Dambappa

³

2020

Preprint

0

View full text Add to dashboard Cite

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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Rib fixation: Who, What, When?

Cited by 81 publications

References 24 publications

Epidemiology and outcome of rib fractures: a nationwide study in the Netherlands

Epidemiology and outcome of rib fractures: a nationwide study in the Netherlands

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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