Kerrie E Buehler1, Candice L Wilshire1, Adam J Bograd1, Eric Vallières2. 1. Department of Thoracic Surgery, Swedish Cancer Institute, 1101 Madison St, Suite 900, Seattle, WA, 98104. 2. Department of Thoracic Surgery, Swedish Cancer Institute, 1101 Madison St, Suite 900, Seattle, WA, 98104. Electronic address: eric.vallieres@swedish.org.
Abstract
BACKGROUND: Although open reduction and internal fixation (ORIF) is an accepted treatment for a proportion of acute rib fractures, there is paucity of literature on its potential to treat chronic, non-union fractures. This study evaluates the outcomes and quality of life of patients who underwent ORIF for chronic, symptomatic non-union rib fractures. METHODS: Thirty two patients were explored for possible ORIF of non-union rib fractures (> 6 months after injury). After excluding non-English speaking patients (n=1), those where no instability was noted at surgery (n=3), and those deceased at the time of study (n=4), 24 patients were eligible. Telephone interviews were conducted using a previously published rib fracture pain questionnaire. RESULTS: Seventy percent (19/24) of eligible patients consented and completed the questionnaire at a median time from surgery of 55 months (interquartile range [IQR]: 24-62 months). Injuries were classified as multi-system trauma (n=4) or isolated rib fractures (n=15). The median pain severity (on a scale of 1 [none/mild] -10 [severe]) significantly decreased from preoperatively (9, IQR: 7-10) to postoperatively (1, IQR: 0-2); p<0.001. The majority of patients returned to daily activities, were able to work at their pre-injury level, were satisfied with their surgery and would undergo operative management again. CONCLUSIONS: Patients who underwent ORIF reported a significant decrease in fracture-associated symptoms and pain severity postoperatively. The majority returned to daily activities, work at pre-injury levels and were satisfied with surgery. ORIF should be considered as an option to help patients with symptomatic non-union rib fractures.
BACKGROUND: Although open reduction and internal fixation (ORIF) is an accepted treatment for a proportion of acute rib fractures, there is paucity of literature on its potential to treat chronic, non-union fractures. This study evaluates the outcomes and quality of life of patients who underwent ORIF for chronic, symptomatic non-union rib fractures. METHODS: Thirty two patients were explored for possible ORIF of non-union rib fractures (> 6 months after injury). After excluding non-English speaking patients (n=1), those where no instability was noted at surgery (n=3), and those deceased at the time of study (n=4), 24 patients were eligible. Telephone interviews were conducted using a previously published rib fracture pain questionnaire. RESULTS: Seventy percent (19/24) of eligible patients consented and completed the questionnaire at a median time from surgery of 55 months (interquartile range [IQR]: 24-62 months). Injuries were classified as multi-system trauma (n=4) or isolated rib fractures (n=15). The median pain severity (on a scale of 1 [none/mild] -10 [severe]) significantly decreased from preoperatively (9, IQR: 7-10) to postoperatively (1, IQR: 0-2); p<0.001. The majority of patients returned to daily activities, were able to work at their pre-injury level, were satisfied with their surgery and would undergo operative management again. CONCLUSIONS:Patients who underwent ORIF reported a significant decrease in fracture-associated symptoms and pain severity postoperatively. The majority returned to daily activities, work at pre-injury levels and were satisfied with surgery. ORIF should be considered as an option to help patients with symptomatic non-union rib fractures.
Authors: Daniel T DeGenova; Klay B Miller; Tanner T McClure; Hayden B Schuette; Bruce G French; Benjamin C Taylor Journal: Arch Orthop Trauma Surg Date: 2022-07-13 Impact factor: 2.928
Authors: Suzanne F M Van Wijck; Esther M M Van Lieshout; Jonne T H Prins; Michael H J Verhofstad; Pieter J Van Huijstee; Jefrey Vermeulen; Mathieu M E Wijffels Journal: Eur J Trauma Emerg Surg Date: 2022-01-27 Impact factor: 2.374