Rib osteosynthesis is a safe and effective treatment and leads to a significant reduction of trauma associated pain
- 15 Downloads
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.
KeywordsRib osteosynthesis Locking plates Intramedullary splints Blunt chest trauma
Compliance with ethical standards
Conflict of interest
The authors declare that they have no competing interests.
- 2.Ciraulo DL, Elliott D, Mitchell KA, Rodriguez A. Flail chest as a marker for significant injuries. J Am Coll Surg. 1994;178(5):466–70.Google Scholar
- 4.Tanaka H, Yukioka T, Yamaguti Y, Shimizu S, Goto H, Matsuda H, et al. Surgical stabilization of internal pneumatic stabilization? A prospective randomized study of management of severe flail chest patients. J Trauma. 2002;52(4):727–32.Google Scholar
- 7.Cataneo AJM, Cataneo DC, de Oliveira FHS, Arruda KA, El Dib R, de Oliveira Carvalho PE. Surgical versus nonsurgical interventions for flail chest. Cochrane Database Syst Rev. 2015;7:CD009919.Google Scholar
- 14.Jones TB, Richardson EP. Traction on the sternum in the treatment of multiple fractured ribs. Surg Gynecol Obstet. 1926;42:283–5.Google Scholar
- 16.Dor V, Paoli JM, Noirclerc M, Malmejac C, Chauvin G, Pons R. Osteosynthesis of the thoracic wall: technic, results and indications: apropos of 19 cases. Ann Chir. 1967;21:983–96.Google Scholar