Rib fracture fixation in a South African public trauma service

Area of Science:

• Trauma surgery
• Thoracic surgery
• Surgical innovation

Background:

• Traditionally, rib fractures and flail chests were managed nonoperatively.
• Recent evidence supports surgical fixation for severe rib fractures.
• Our unit implemented rib fracture fixation in 2014.

Purpose of the Study:

• To audit the feasibility of rib fracture fixation in a public sector setting.
• To evaluate outcomes following surgical intervention for severe rib fractures.

Main Methods:

• Audit of nine consecutive cases of rib fracture fixation.
• Analysis of patient demographics, injury severity, and operative timing.
• Assessment of outcomes including ventilator weaning, ICU stay, and hospital discharge.

Main Results:

• Seven of nine patients were male, aged 29-67 years.
• All patients had multiple, severely displaced rib fractures, including unilateral or bilateral flail chests.
• Ventilator-dependent patients were liberated within 3 days post-fixation (except one with TBI); ICU discharge within 5 days.
• Hospital discharge occurred within 5-8 days for patients without other significant injuries.
• Minor complications included pleural breach (2) and superficial wound infection (1).

Conclusions:

• Rib fracture fixation is a safe and feasible procedure.
• The findings support the feasibility of rib fracture fixation in the South African public sector.