title: Potential Benefits of Rib Fracture Fixation in Patients with Flail Chest and Multiple Non-flail Rib Fractures.
abstract: The purpose of this study is to evaluate the potential benefits of rib fracture fixation in patients with flail chest and multiple non-flail rib fractures versus conventional treatment modalities. A retrospective reviewed study compared 86 cases which received surgical treatment between June 2009 and May 2013 to 76 cases which received conservative treatment between January 2006 and May 2009. The patients were divided into the flail chest (n= 38) and multiple non-flail rib fracture groups (n= 124). In the flail chest group, the mechanical ventilation time, ICU monitoring time, tracheostomies, thoracic deformity, and impaired pulmonary function and return to full-time employment were compared. In the multiple non-flail rib fracture group, fracture healing, visual analog scale (VAS) pain score, inpatient length of stay, atelectatic, pulmonary complications, and normal activity-returning time were compared. Patients in the flail chest operative fixation group had significantly shorter ICU stay, decreased ventilator requirements, fewer tracheostomies, less thoracic deformity and impaired pulmonary function, and more returned to full-time employment. Patients in the multiple non-flail rib fracture operative fixation had shorter hospital stay, less pain, earlier return to normal activity, more fracture healing, less atelectasis, and fewer pulmonary infections. This study demonstrates the potential benefits of surgical stabilization of flail chest and multiple non-flail rib fractures with plate fixation. When compared with conventional conservative management, operatively managed patients demonstrated improved clinical outcomes.
authors.affiliation: Department of Orthopaedic Surgery, Nanfang Hospital, Southern Medical University, No. 1838 North Guangzhou Road, Guangzhou, 510515 Guangdong China ; Emergency Center of Surgery, Fujian Provincial Hospital, Provincial Clinical Hospital of Fujian Medical University, Fuzhou, 350001 China.
authors.forename: Meiguang
authors.initials: M
authors.lastname: Qiu
authors.affiliation: Department of Orthopaedic Surgery, Nanfang Hospital, Southern Medical University, No. 1838 North Guangzhou Road, Guangzhou, 510515 Guangdong China.
authors.forename: Zhanjun
authors.initials: Z
authors.lastname: Shi
authors.affiliation: Department of Orthopaedic Surgery, Nanfang Hospital, Southern Medical University, No. 1838 North Guangzhou Road, Guangzhou, 510515 Guangdong China.
authors.forename: Jun
authors.initials: J
authors.lastname: Xiao
authors.affiliation: Emergency Center of Surgery, Fujian Provincial Hospital, Provincial Clinical Hospital of Fujian Medical University, Fuzhou, 350001 China.
authors.forename: Xuming
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Emergency Center of Surgery, Fujian Provincial Hospital, Provincial Clinical Hospital of Fujian Medical University, Fuzhou, 350001 China.
authors.forename: Shishui
authors.initials: S
authors.lastname: Ling
authors.affiliation: Emergency Center of Surgery, Fujian Provincial Hospital, Provincial Clinical Hospital of Fujian Medical University, Fuzhou, 350001 China.
authors.forename: Hao
authors.initials: H
authors.lastname: Ling
keywords: Conservative treatment; Flail chest; Internal fixation; Non-flail chest