title: Open reduction and internal fixation of rib fractures in polytrauma patients with flail chest.
abstract: BACKGROUND
  Open reduction and internal fixation (ORIF) of fractured ribs for flail chest is safe and effective but who is most likely to benefit is unknown. Our purpose is to compare ORIF with nonoperative management (NOM) in polytrauma patients.
  
  
  METHODS
  Albany Medical Center Hospital Trauma Registry was queried for adult patients with flail chest admitted over 7 years.
  
  
  RESULTS
  Eighty-six patients with radiographic flail chest were identified who met inclusion criteria. The 41 ORIF and 45 NOM patients had similar demographics and injury severity. Hospital length of stay and intensive care unit length of stay were significantly longer in the ORIF group than that of the NOM group. There was a trend toward longer time on the ventilator in the ORIF group.
  
  
  CONCLUSIONS
  In this retrospective study, patients treated by ORIF had longer hospitalization and ventilator duration. Future studies should be designed to optimally identify patients who are most likely to benefit from ORIF.
authors.affiliation: Division of Trauma and Critical Care, Department of Surgery, Albany Medical Center Hospital, 42 New Scotland Avenue, 194 Albany, NY, 12208-3479, USA. Electronic address: defreela@mail.amc.edu.
authors.forename: Lori
authors.initials: L
authors.lastname: DeFreest
authors.affiliation: Division of Trauma and Critical Care, Department of Surgery, Albany Medical Center Hospital, 42 New Scotland Avenue, 194 Albany, NY, 12208-3479, USA.
authors.forename: Marcel
authors.initials: M
authors.lastname: Tafen
authors.affiliation: Division of Trauma and Critical Care, Department of Surgery, Albany Medical Center Hospital, 42 New Scotland Avenue, 194 Albany, NY, 12208-3479, USA.
authors.forename: Avinash
authors.initials: A
authors.lastname: Bhakta
authors.affiliation: Division of Trauma and Critical Care, Department of Surgery, Albany Medical Center Hospital, 42 New Scotland Avenue, 194 Albany, NY, 12208-3479, USA.
authors.forename: Ashar
authors.initials: A
authors.lastname: Ata
authors.affiliation: Division of Trauma and Critical Care, Department of Surgery, Albany Medical Center Hospital, 42 New Scotland Avenue, 194 Albany, NY, 12208-3479, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Martone
authors.affiliation: Division of Trauma and Critical Care, Department of Surgery, Albany Medical Center Hospital, 42 New Scotland Avenue, 194 Albany, NY, 12208-3479, USA.
authors.forename: Owen
authors.initials: O
authors.lastname: Glotzer
authors.affiliation: Division of Trauma and Critical Care, Department of Surgery, Albany Medical Center Hospital, 42 New Scotland Avenue, 194 Albany, NY, 12208-3479, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Krautsak
authors.affiliation: Division of Trauma and Critical Care, Department of Surgery, Albany Medical Center Hospital, 42 New Scotland Avenue, 194 Albany, NY, 12208-3479, USA.
authors.forename: Carl
authors.initials: C
authors.lastname: Rosati
authors.affiliation: Division of Trauma and Critical Care, Department of Surgery, Albany Medical Center Hospital, 42 New Scotland Avenue, 194 Albany, NY, 12208-3479, USA.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Stain
authors.affiliation: Division of Trauma and Critical Care, Department of Surgery, Albany Medical Center Hospital, 42 New Scotland Avenue, 194 Albany, NY, 12208-3479, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Bonville
mesh_terms: D003710:Demography; D005260:Female; D005409:Flail Chest / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma; D012042:Registries; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012253:Rib Fractures / Q000601:surgery*; D014193:Trauma Centers
keywords: Flail chest; Nonoperative management; ORIF; Open reduction and internal fixation; Rib fractures; Surgical stabilization