Chest Wall Stabilization in Trauma Patients with Rib Fractures: A Systematic Review
Anthony J. Duncan MDa, Ikttesh K. Chahal, MDa, Mentor Ahmeti, MD FACS FKCSa,b
aUniversity of North Dakota, School of Medicine & Health Sciences, Department of Surgery
1919 North Elm Fargo, ND 58102
bSanford Medical Center Fargo,
Department of Trauma and Acute Care Surgery
5225 23rd Ave. S. Fargo, North. Dakota 58104
Corresponding author:
Mentor Ahmeti, MD, FACS, FKCS, University of North Dakota, School of Medicine & Health Sciences Department of Surgery 1919 North Elm Fargo, ND 58102, [email protected]
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Abstract
Background: The incidence of rib fractures remains high among trauma patients, serving as a significant source of morbidity and mortality. Outcomes are further impacted by the presence of a flail segment, multiple rib fractures, or in elderly patients. In recent years, there has been an increase in the utilization and research into chest wall stabilization. Due to heterogeneity of the rib fracture pathology, concomitant injuries and patient variability there has been challenges to develop strict indication guidelines that can be generalized in this patient population.
Method: We present a literature review of PubMed and Google Scholar. After review 30 papers met inclusion criteria. Outcomes of interest include mortality rates, length of stay in the intensive care unit (ICU) and hospital, post-operative pain, and post-operative complications.
Results: Data reports a decrease in in both the ICU and hospital length of stay. Studies show a decreased post-operative pain with chest wall stabilization when compared to non-operative management. Interestingly, these benefits appeared to be most prominent within 72 hours post-surgery.
Conclusion: Although some studies show no difference in these variables, most of the data shows a non-conclusive signal that chest wall stabilization surgeries might be a viable option with some impact on the morbidity and mortality in select patients with rib fractures.