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European Journal of Trauma and Emergency Surgery

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Open Access 01-08-2019 | Original Article

Long-term follow-up after rib fixation for flail chest and multiple rib fractures

Authors: Reinier B. Beks, Mirjam B. de Jong, Roderick M. Houwert, Arthur A. R. Sweet, Ivar G. J. M. De Bruin, Geertje A. M. Govaert, Karlijn J. P. Wessem, Rogier K. J. Simmermacher, Falco Hietbrink, Rolf H. H. Groenwold, Luke P. H. Leenen

Published in: European Journal of Trauma and Emergency Surgery | Issue 4/2019

Abstract

Purpose

Rib fixation for flail chest has been shown to improve in-hospital outcome, but little is known about treatment for multiple rib fractures and long-term outcome is scarce. The aim of this study was to describe the safety, long-term quality of life, and implant-related irritation after rib fixation for flail chest and multiple rib fractures.

Methods

All adult patients with blunt thoracic trauma who underwent rib fixation for flail chest or multiple rib fractures between January 2010 and December 2016 in our level 1 trauma facility were retrospectively included. In-hospital characteristics and implant removal were obtained via medical records and long-term quality of life was assessed over the telephone.

Results

Of the 864 patients admitted with ≥ 3 rib fractures, 166 (19%) underwent rib fixation; 66 flail chest patients and 99 multiple rib fracture patients with an ISS of 24 (IQR 18–34) and 21 (IQR 16–29), respectively. Overall, the most common complication was pneumonia (n = 58, 35%). Six (9%) patients with a flail chest and three (3%) with multiple rib fractures died, only one because of injuries related to the thorax. On average at 3.9 years, follow-up was obtained from 103 patients (62%); 40 with flail chest and 63 with multiple rib fractures reported an EQ-5D index of 0.85 (IQR 0.62–1) and 0.79 (0.62–0.91), respectively. Forty-eight (48%) patients had implant-related irritation and nine (9%) had implant removal.

Conclusions

We show that rib fixation is a safe procedure and that patients reported a relative good quality of life. Patients should be counseled that after rib fixation approximately half of the patients will experience implant-related irritation and about one in ten patients requires implant material removal.

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Title: Long-term follow-up after rib fixation for flail chest and multiple rib fractures
Authors: Reinier B. Beks
Mirjam B. de Jong
Roderick M. Houwert
Arthur A. R. Sweet
Ivar G. J. M. De Bruin
Geertje A. M. Govaert
Karlijn J. P. Wessem
Rogier K. J. Simmermacher
Falco Hietbrink
Rolf H. H. Groenwold
Luke P. H. Leenen
Publication date: 01-08-2019
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Trauma and Emergency Surgery / Issue 4/2019
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-018-1009-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Long-term follow-up after rib fixation for flail chest and multiple rib fractures

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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