Timing of Surgical Stabilization of Rib Fractures
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Purpose of Review
Surgical stabilization of rib fractures (SSRF) has a proven benefit in patients with flail chest. However, the timing of intervention is currently unclear. We aim to evaluate and summarize current evidence related to the time interval for the surgical stabilization of rib fractures.
Retrospective studies specifically addressing when to perform SSRF in patients with severely displaced rib fractures have reported a benefit for patients who underwent the procedure within 72 h of injury. There are currently no prospective trials specifically addressing timing of rib fixation. Delayed (i.e., months to years) SSRF may be indicated in highly select cases with both physical exam findings of “clicking” or instability and radiographic evidence of nonunion.
For patients in whom there are no contra-indications, current evidence suggests that surgical stabilization of rib fractures should occur as early as possible, and ideally within 72 h of injury. The decision to perform delayed SSRF should be undertaken cautiously and on a case-by-case basis.
KeywordsSurgical stabilization of rib fractures Rib plating Rib fixation Flail chest Chest wall trauma
Compliance with Ethical Guidelines
Conflict of interest
Michal Radomski declares no potential conflicts of interest. Fredric Pieracci is a paid educator and has received research funding from DePuy Synthes.
Human and Animal Rights
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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