Rib osteosynthesis is a safe and effective treatment and leads to a significant reduction of trauma associated pain

  • Ali Akil
  • Stephan Ziegeler
  • Jan Reichelt
  • Michael Semik
  • Marcus Christian Müller
  • Stefan FischerEmail author
Original Article



The usefulness of chest wall stabilization after blunt chest wall trauma with unstable rib fractures has recently been intensely discussed. Thereby, the surgical approach seems to influence outcome, mortality and the long-term complication rate including chronic chest pain, thoracic deformity and quality of life. Here, we present the outcome after surgical stabilization of unstable rib fractures using intramedullary splints and plate osteosynthesis.


n = 50 patients were enrolled in this trial. Surgical stabilization was performed using intramedullary splints and/or plate osteosynthesis. Video-assisted thoracoscopy was performed in all patients for the inspection of the thoracic cavity and to exactly localize the fractured ribs. The pre- and postoperative pain course was documented using the visual analog scale.


A total of n = 50 patients (10 females, mean age 63 years) were included into the analysis. All patients presented with traumatic serial rib fractures with a mean of 3 fractured ribs (range 2–8 ribs) and an unstable thorax wall. Rib osteosynthesis was performed using intramedullary splints (n = 17 patients), locking plates (n = 17 patients), or a combined use of both procedures (n = 16 patients). Mean operating time was 80 min (31–161 min). No major complications were seen intra- and postoperatively. Mean hospital stay was 8 ± 2 days (2–21 days). In all patients, excellent chest wall stability was achieved. Moreover, a significant reduction of pain was observed (2.6 ± 0.3 postoperatively vs. 8 ± 1.15 preoperatively, p < 0.0001) already during the hospital stay.


Rib osteosynthesis is a safe and effective treatment option for patients with unstable rib fractures after blunt chest wall trauma. It leads to a significant reduction of the trauma-associated pain caused by the rib fractures and supports a quick recovery of the patients.


Rib osteosynthesis Locking plates Intramedullary splints Blunt chest trauma 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Thoracic Surgery and Lung SupportIbbenbueren General HospitalIbbenbuerenGermany
  2. 2.Department of Anesthesia, Intensive Care Medicine and Pain ManagementIbbenbueren General HospitalIbbenbuerenGermany
  3. 3.Department of Trauma and Orthopedic SurgeryIbbenbueren General HospitalIbbenbuerenGermany

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