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Rib fixation: Who, What, When?

Marc de Moya¹, Ram Nirula², Walter Biffl^3,4

¹Division of Trauma, Acute Care Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Trauma Surgery & Acute Care Open

|May 17, 2018

Summary

This summary is machine-generated.

Rib fractures are a common thoracic trauma. Surgical fixation of severe rib fractures, like flail chest, may improve outcomes, though its use in less severe cases is debated.

Keywords:

Chest wall Ribs rib fractures

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Area of Science:

Trauma Surgery
Thoracic Surgery
Orthopedic Surgery

Background:

Rib fractures are common in thoracic trauma, often linked to lung contusion and increased mortality.
Flail chest, defined by multiple consecutive rib fractures, is associated with significant morbidity, especially in the elderly.
Current treatment focuses on pain management and respiratory support, but surgical fixation is gaining attention.

Purpose of the Study:

To review current evidence on surgical fixation for rib fractures.
To discuss the benefits of open reduction and internal fixation (ORIF) for severe rib fractures.
To propose indications for surgical intervention in patients with rib fractures.

Main Methods:

Review of current scientific literature on rib fracture treatment.
Analysis of evidence supporting surgical fixation versus conservative management.
Synthesis of expert opinion on treatment indications.

Main Results:

Mounting evidence suggests open reduction and internal fixation (ORIF) benefits select patients with severe rib fractures.
ORIF is currently indicated for flail chest and chronic non-unions.
Debate exists regarding the benefits of ORIF for less severely injured patients.

Conclusions:

Surgical fixation of rib fractures, particularly flail chest, shows promise for improving patient outcomes.
Further research and clear guidelines are needed to define optimal indications for surgical intervention.
Expert opinion supports a role for ORIF in carefully selected, severely injured patients.