Literature DB >> 30596069

Surgical versus conservative therapy for multiple rib fractures: a retrospective analysis.

Yongjing Liu1, Shun Xu1, Qi Yu1, Yu Tao1, Leilei Peng1, Shengbo Qi1, Hao Han1, Mengran Chen1.   

Abstract

BACKGROUND: In this study, we aimed to evaluate the clinical effects of multiple rib fracture treatments using a rib plate fixator.
METHODS: From June 2014 to December 2016, 110 cases of patients with multiple rib fractures were collected for our study from the 105th Hospital of PLA; 59 patients were treated by surgery, and 51 patients received conservative treatment. We compared surgical rib plate fixation with conservative treatment for patients with multiple rib fractures.
RESULTS: The hospital stay for the surgical group was 13.12±4.21 days, whereas for the conservative group, it was 18.57±5.39 days (P<0.001). The duration of the thoracic intensive care unit (ICU) stay was 4.02±1.41 days in the surgical group and 5.06±1.80 days in the conservative group (P=0.001). The indwelling thoracic drainage tube time was 5.85±1.52 days in the surgical group and 8.26±1.96 days in the conservative group (P<0.001). The index of partial pressure of arterial oxygen (PaO2) was 91.05±10.88 mmHg 24 h after surgery whereas 86.49±11.69 mmHg 24 h after conservative treatment (P=0.036). The index of partial pressure of carbon dioxide (PaCO2) was 37.80±2.86 mmHg 24 h after surgery and it was 39.08±2.46 mmHg 24 h after conservative treatment. The hospitalization cost was 6,206.44±371.42 USD for the surgical group and 4,544.61±524.79 USD for the conservative group (P<0.001). The number of rib displacement cases after treatment was 1 case in the surgical group and 2 cases in the conservative group (P=0.475). Atelectasis occurred in 10 cases in the surgical group and in 17 cases in the conservative group (P=0.046). Delayed hemopneumothorax occurred in 7 cases in the surgical group and in 16 cases in the conservative group (P=0.012).
CONCLUSIONS: Surgical treatment is a safe and effective therapy for multiple rib fractures. Our data suggested that surgical treatment can significantly shorten the patients' pain-endurance time, hospitalization time, and can reduce complication incidence. Severe rib fracture patients might benefit from surgical fixation.

Entities:  

Keywords:  Plate fixator; multiple rib fractures; surgical

Year:  2018        PMID: 30596069      PMCID: PMC6281531          DOI: 10.21037/atm.2018.10.12

Source DB:  PubMed          Journal:  Ann Transl Med        ISSN: 2305-5839


  33 in total

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4.  Rib fracture stabilization in patients sustaining blunt chest injury.

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5.  Open fixation in flail chest: review of 64 patients.

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6.  A comprehensive analysis of traumatic rib fractures: morbidity, mortality and management.

Authors:  Mehmet Sirmali; Hasan Türüt; Salih Topçu; Erkmen Gülhan; Ulkü Yazici; Sadi Kaya; Irfan Taştepe
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7.  Morbidity from rib fractures increases after age 45.

Authors:  John B Holcomb; Neil R McMullin; Rosemary A Kozar; Marjorie H Lygas; Frederick A Moore
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Review 8.  The management of flail chest.

Authors:  Brian L Pettiford; James D Luketich; Rodney J Landreneau
Journal:  Thorac Surg Clin       Date:  2007-02       Impact factor: 1.750

9.  Operative fixation of chest wall fractures: an underused procedure?

Authors:  J David Richardson; Glen A Franklin; Susan Heffley; David Seligson
Journal:  Am Surg       Date:  2007-06       Impact factor: 0.688

10.  Rib fracture pain and disability: can we do better?

Authors:  Mahlon A Kerr-Valentic; Melanie Arthur; Richard J Mullins; Tuesday E Pearson; John C Mayberry
Journal:  J Trauma       Date:  2003-06
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  1 in total

1.  Effects of erector spinae plane block and retrolaminar block on analgesia for multiple rib fractures: a randomized, double-blinded clinical trial.

Authors:  Yaoping Zhao; Yan Tao; Shaoqiang Zheng; Nan Cai; Long Cheng; Hao Xie; Geng Wang
Journal:  Braz J Anesthesiol       Date:  2021-04-22
  1 in total

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