Outcomes of Trauma Patients with Flail Chest and Surgical Rib Stabilization

Abstract

The goal of this project was to describe the current practices of this institution and identify which patients benefit from surgical stabilization of rib fractures (SSRF). A total of 1429 trauma patients admitted to our Level 1 center with rib fractures between January 1, 2014 and June 22, 2020 were retrospectively reviewed. Flail chest was observed in 43 (3.01%) patients. Surgical stabilization of rib fractures was pursued in 27 of all patients (1.89%). Twenty-four flail chest patients required intubation (ETT). Nineteen were not intubated (NoET). Of the ETT group, 8 underwent SSRF and 16 did not. Those who had SSRF had a shorter ventilator Length of Stay (7.1 vs 15.7 d) and Intensive Care Unit Length of Stay (9.8 vs 11.9 d). Surgical stabilization of rib fractures has shown success in managing flail chest. In intubated patients with flail chest, fixation seems to decrease Intensive Care Unit stays and the duration of ventilation. We believe we need to perform SSRF on more patients with flail chest.

Keywords

flail chest rib fixation surgical stabilization of rib fractures rib fracture

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References

Galvagno

Jr Smith

Varon

, et al. Pain management for blunt thoracic trauma: A joint practice management guideline from the Eastern association for the surgery of trauma and trauma anesthesiology society. J Trauma Acute Care Surg. 2016;81(5):936-951.

de Moya

Nirula

Biffl

. Rib fixation: Who, what, when? Trauma Surg Acute Care Open. 2017;2(1):e000059.

Kasotakis

Hasenboehler

Streib

, et al. Operative fixation of rib fractures after blunt trauma: A practice management guideline from the Eastern association for the surgery of trauma. J Trauma Acute Care Surg. 2017;82(3):618-626.

Dehghan

de Mestral

McKee

Schemitsch

Nathens

. Flail chest injuries: A review of outcomes and treatment practices from the National trauma data bank. J Trauma Acute Care Surg. 2014;76(2):462-468.