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Muhm M, Härter J, Weiss C, et al. Severe trauma of the chest wall: surgical rib stabilisation versus non-operative treatment. Eur J Trauma Emerg Surg. 2013;39(3):257-65doi: 10.1007/s00068-013-0262-x.
Muhm, M., Härter, J., Weiss, C., & Winkler, H. (2013). Severe trauma of the chest wall: surgical rib stabilisation versus non-operative treatment. European journal of trauma and emergency surgery : official publication of the European Trauma Society, 39(3), 257-65. https://doi.org/10.1007/s00068-013-0262-x
Muhm, M, et al. "Severe trauma of the chest wall: surgical rib stabilisation versus non-operative treatment." European journal of trauma and emergency surgery : official publication of the European Trauma Society vol. 39,3 (2013): 257-65. doi: https://doi.org/10.1007/s00068-013-0262-x
Muhm M, Härter J, Weiss C, Winkler H. Severe trauma of the chest wall: surgical rib stabilisation versus non-operative treatment. Eur J Trauma Emerg Surg. 2013 Jun;39(3):257-65. doi: 10.1007/s00068-013-0262-x. Epub 2013 Feb 16. PMID: 26815232.
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Eur J Trauma Emerg Surg. 2013 Jun;39(3):257-65. doi: 10.1007/s00068-013-0262-x. Epub 2013 Feb 16.

Severe trauma of the chest wall: surgical rib stabilisation versus non-operative treatment.

European journal of trauma and emergency surgery : official publication of the European Trauma Society

M Muhm, J Härter, C Weiss, H Winkler

Affiliations

  1. Department of Trauma and Orthopaedic Surgery, Westpfalz-Klinikum Kaiserslautern, Hellmut-Hartert-Str. 1, 67655, Kaiserslautern, Germany. [email protected].
  2. Department of Trauma and Orthopaedic Surgery, Medical Faculty Mannheim, Heidelberg University and Mainz University, Heidelberg, Germany. [email protected].
  3. Department of Trauma and Orthopaedic Surgery, Medical Faculty Mannheim, Heidelberg University and Mainz University, Heidelberg, Germany.
  4. Department of Medical Statistics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.

PMID: 26815232 DOI: 10.1007/s00068-013-0262-x

Abstract

BACKGROUND: Serial rib fractures and flail chest injury can be treated by positive-pressure ventilation. Operative techniques reduce intensive care unit (ICU) stay, overall costs, mortality and morbidity, as well as pain. The aim of this study was to evaluate the benefit of surgical rib stabilisation in comparison to non-operative treatment in patients with severe trauma of the chest wall.

MATERIALS AND METHODS: From 2006 to 2011, the data of 44 patients with flail chest and serial rib fractures were collected retrospectively. A surgical group and an intensive care group with only intensive care therapy were formed. Rib and sternal fractures, flail chest, injury severity, thoracic injuries, mechanical ventilation, time in the ICU, overall hospital stay and mortality were evaluated.

RESULTS: No postoperative surgical complications had been observed. The time under mechanical ventilation in the surgical group was 10.6 ± 10.2 days, whereas in the non-surgical group, it was 13.7 ± 13.7 days. Mechanical ventilation time after surgery was 6.9 ± 6.5 days. Time in the ICU for the surgical group was 16.4 ± 13.6 days, compared to the non-surgical group with 20.1 ± 16.2 days. Postoperative time in the ICU was 11.7 ± 10.3 days. The mortality in the surgical group was 10 % and in the non-surgical group it was 17 %.

CONCLUSIONS: Operative rib stabilisation with plates is a safe therapy option for severe trauma of the chest wall. Provided that the duration of preoperative mechanical ventilation and time spent in the ICU is minimised due to early operation, our data suggest that the stabilisation of serial rib fractures and flail chest may lead to a reduced time of mechanical ventilation, time in the ICU and mortality.

Keywords: Flail chest; Hospital stay; Mechanical ventilation; Serial rib fracture; Surgical rib stabilisation; Thoracic injury

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