title: Physical function and pain after surgical or conservative management of multiple rib fractures - a follow-up study.
abstract: BACKGROUND
  There is scarce knowledge of physical function and pain due to multiple rib fractures following trauma. The purpose of this follow-up was to assess respiratory and physical function, pain, range of movement and kinesiophobia in patients with multiple rib fractures who had undergone stabilizing surgery and compare with conservatively managed patients.
  
  
  METHODS
  A consecutive series of 31 patients with multiple rib fractures who had undergone stabilizing surgery were assessed >1 year after the trauma concerning respiratory and physical function, pain, range of movement in the shoulders and thorax, shoulder function and kinesiophobia. For comparison, 30 patients who were treated conservatively were evaluated with the same outcome measures.
  
  
  RESULTS
  The results concerning pain, lung function, shoulder function and level of physical activity were similar in the two groups. The patients who had undergone surgery had a significantly larger range of motion in the thorax (p < 0.01) and less deterioration in two items in Disability Rating Index (sitting and standing bent over a sink) (p < 0.05).
  
  
  CONCLUSIONS
  It is questionable whether the control group is representative since the majority of patients were invited but refused to participate in the follow-up. In addition, this study is too small to make a definitive conclusion if surgery is better than conservative treatment. But we see some indications, such as a tendency for decreased pain, better thoracic range of motion and physical function which would indicate that surgery is preferable. If operation technique could improve in the future with a less invasive approach, it would presumably decrease post-operative pain and the benefit of surgery would be greater than the morbidity of surgery.
  
  
  CONCLUSIONS
  Patients undergoing surgery have a similar long-term recovery to those who are treated conservatively except for a better range of motion in the thorax and fewer limitations in physical function. Surgery seems to be beneficial for some patients, the question remains which patients.
  
  
  BACKGROUND
  FoU i Sverige (R&D in Sweden), No 106121.
authors: Department of Gastrosurgical Research and Education, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden. monika.fagevik-olsen@vgregion.se.|Department of Physical Therapy, Sahlgrenska University Hospital and Sahlgrenska Academy at Gothenburg University, Gothenburg, SE 413 45, Sweden. monika.fagevik-olsen@vgregion.se.
authors: Monika
authors: M
authors: Fagevik Olsén
authors: Department of Physical Therapy, Sahlgrenska University Hospital and Sahlgrenska Academy at Gothenburg University, Gothenburg, SE 413 45, Sweden.
authors: Margareta
authors: M
authors: Slobo
authors: Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors: Lena
authors: L
authors: Klarin
authors: Department of Surgery, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
authors: Eva-Corina
authors: EC
authors: Caragounis
authors: Department of Surgery, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
authors: David
authors: D
authors: Pazooki
authors: Department of Surgery, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
authors: Hans
authors: H
authors: Granhed
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000072700:Conservative Treatment / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D009104:Multiple Trauma / Q000628:therapy*; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D010147:Pain Measurement; D012189:Retrospective Studies; D012253:Rib Fractures / Q000628:therapy*; D013548:Sweden; D013997:Time Factors; D055815:Young Adult
keywords: Flail chest; Range of motion; Rib cage; Ribs; Spirometry