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European Journal of Trauma and Emergency Surgery
Published in: European Journal of Trauma and Emergency Surgery 4/2017

01-08-2017 | Original Article

Evaluation of efficacy and indications of surgical fixation for multiple rib fractures: a propensity-score matched analysis

Authors: K. Uchida, T. Nishimura, H. Takesada, T. Morioka, N. Hagawa, T. Yamamoto, S. Kaga, T. Terada, N. Shinyama, H. Yamamoto, Y. Mizobata

Published in: European Journal of Trauma and Emergency Surgery | Issue 4/2017

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Abstract

Purpose

The purpose of this study was to assess the effects of recent surgical rib fixation and establish its indications not only for flail chest but also for multiple rib fractures.

Methods

Between 2007 and 2015, 187 patients were diagnosed as having multiple rib fractures in our institution. After the propensity score matching was performed, ten patients who had performed surgical rib fixation and ten patients who had treated with non-operative management were included. Categorical variables were analyzed with Fischer’s exact test and non-parametric numerical data were compared using the Mann–Whitney U test. Wilcoxon signed-rank test was performed for comparison of pre- and postoperative variables. All statistical data are presented as median (25–75 % interquartile range [IQR]) or number.

Results

The surgically treated patients extubated significantly earlier than non-operative management patients (5.5 [1–8] vs 9 [7–12] days: p = 0.019). The duration of continuous intravenous narcotic agents infusion days (4.5 [3–6] vs 12 [9–14] days: p = 0.002) and the duration of intensive care unit stay (6.5 [3–9] vs 12 [8–14] days: p = 0.008) were also significantly shorter in surgically treated patients. Under the same ventilating conditions, the postoperative values of tidal volume and respiratory rate improved significantly compared to those values measured just before the surgery. The incidence of pneumonia as a complication was significantly higher in non-operative management group (p = 0.05).

Conclusions

From the viewpoints of early respiratory stabilization and intensive care unit disposition without any complications, surgical rib fixation is a sufficiently acceptable procedure not only for flail chest but also for repair of severe multiple rib fractures.
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Metadata
Title
Evaluation of efficacy and indications of surgical fixation for multiple rib fractures: a propensity-score matched analysis
Authors
K. Uchida
T. Nishimura
H. Takesada
T. Morioka
N. Hagawa
T. Yamamoto
S. Kaga
T. Terada
N. Shinyama
H. Yamamoto
Y. Mizobata
Publication date
01-08-2017
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Trauma and Emergency Surgery / Issue 4/2017
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-016-0687-0

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