Prospective Randomized Controlled Trial of Operative Rib Fixation in Traumatic Flail Chest
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- 1 May 2013
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of the American College of Surgeons
- Vol. 216 (5), 924-932
- https://doi.org/10.1016/j.jamcollsurg.2012.12.024
Abstract
Traumatic flail chest injury is a potentially life threatening condition traditionally treated with invasive mechanical ventilation to splint the chest wall. Longer-term sequelae of pain, deformity, and physical restriction are well described. This study investigated the impact of operative fixation in these patients. A prospective randomized study compared operative fixation of fractured ribs in the flail segment with current best practice mechanical ventilator management. In-hospital data, 3-month follow-up review, spirometry and CT, and 6-month quality of life (Short Form-36) questionnaire were collected. Patients in the operative fixation group had significantly shorter ICU stay (hours) postrandomization (285 hours [range 191 to 319 hours] for the surgical group vs 359 hours [range 270 to 581 hours] for the conservative group; p = 0.03) and lesser requirement for noninvasive ventilation after extubation (3 hours [range 0 to 25 hours] in the surgical group vs 50 hours [range 17 to 102 hours] in the conservative group; p = 0.01). No differences in spirometry at 3 months or quality of life at 6 months were noted. Operative fixation of fractured ribs reduces ventilation requirement and intensive care stay in a cohort of multitrauma patients with severe flail chest injury.Keywords
This publication has 11 references indexed in Scilit:
- Structural integrity of intramedullary rib fixation using a single bioresorbable screwThe Journal of Trauma and Acute Care Surgery, 2012
- Open Surgical Fixation of Fractured RibsRecent Patents on Biomedical Engineeringe, 2010
- Pilot study of operative fixation of fractured ribs in patients with flail chestAnz Journal of Surgery, 2009
- Geometry of human ribs pertinent to orthopedic chest-wall reconstructionJournal of Biomechanics, 2007
- The evolution of an integrated State Trauma System in Victoria, AustraliaInjury, 2005
- New insights into the pathophysiology of flail segment: the implications of anterior serratus muscle in parietal failureEuropean Journal of Cardio-Thoracic Surgery, 2005
- Surgical versus conservative treatment of flail chest. Evaluation of the pulmonary statusInteractive CardioVascular and Thoracic Surgery, 2005
- Open Fixation in Flail Chest: Review of 64 PatientsAsian Cardiovascular and Thoracic Annals, 2004
- Comparison of absorbable poly-l-lactide and metallic intramedullary rods in the fixation of femoral shaft osteotomies: an experimental study in rabbitsJournal of Orthopaedic Science, 2001
- Physical functioning and mental health in patients with chronic medical conditionsQuality of Life Research, 1999