SURGICAL MANAGEMENT VERSUS NON-SURGICAL MANAGEMENT OF RIB FRACTURES IN CHEST TRAUMA: A SYSTEMATIC REVIEW

Authors

  • Fulgensius Atin Faculty of Medicine, Widya Mandala Catholic University, Surabaya, Indonesia Author
  • Herbert Soritua Silalahi Siloam General Hospital, Kupang, Indonesia Author
  • R. Dhany Prasetyanto St. Vincentius A Paulo Catholic Hospital, Surabaya, Indonesia Author
  • Fridolino Jimmy Desanto Siloam General Hospital, Kupang, Indonesia Author
  • Heriberty Chindy Sulisty dr. Ben Mboi Central General Hospital, Kupang, Indonesia Author

DOI:

https://doi.org/10.61841/smas5j15

Keywords:

Surgical, non-surgical, rib fractures, flail chest, outcomes, compare

Abstract

Background: Roughly ten percent of patients who visit trauma centers are estimated to have broken ribs. From a single, isolated fracture to a flail chest, rib fractures can occur in a variety of severity. Rib fractures substantially influence the rates of morbidity and mortality. There is still debate on how to treat chest injuries. Practical use varies greatly; one such example is the uneven application of surgical stabilization.

The aim: This study aims to assess the differences between surgical management and non-surgical management of rib fractures in chest trauma.

Methods: By comparing itself to the standards set by the Preferred Reporting Items for Systematic Review and MetaAnalysis (PRISMA) 2020, this study was able to show that it met all of the requirements. So, the experts were able to make sure that the study was as up-to-date as it was possible to be. For this search approach, publications that came out between 2013 and 2023 were taken into account. Several different online reference sources, like Pubmed and ScienceDirect, were used to do this. It was decided not to take into account review pieces, works that had already been published, or works that were only half done.

Results: In the PubMed database, the results of our search brought up 44 articles, whereas the results of our search on ScienceDirect brought up 303 articles. The results of the search conducted by title screening yielded a total 18 articles for PubMed and 13 articles for ScienceDirect. We compiled a total of 17 papers, 12 of which came from PubMed and 5 of which came from ScienceDirect. We excluded 1 review article, 1 duplicate article, 1 non-full text article, 2 protocol study, 2 articles having ineligible subjects, and 3 articles having insufficient outcomes data. In the end, we included seven research that met the criteria.

Conclusion: The outcomes of surgical and non-surgical methods for the management of rib fractures are comparable in terms of complications, length of hospital stay, and mortality.

References

Sarode AL, Ho VP, Pieracci FM, Moorman ML, Towe CW. The financial burden of rib fractures: National estimates 2007 to 2016. Injury. 2021 Aug 1;52(8):2180–7.

Peek J, Beks RB, Hietbrink F, De Jong MB, Heng M, Beeres FJP, et al. Epidemiology and outcome of rib fractures: a nationwide study in the Netherlands. European Journal of Trauma and Emergency Surgery. 2022 Feb 1;48(1):265–71.

Bankhead-Kendall B, Radpour S, Luftman K, Guerra E, Ali S, Getto C, et al. Rib Fractures and Mortality: Breaking the Causal Relationship.

He Z, Zhang D, Xiao H, Zhu Q, Xuan Y, Su K, et al. The ideal methods for the management of rib fractures. Vol. 11, Journal of Thoracic Disease. AME Publishing Company; 2019. p. S1078–89.

Shahid A, Turner T, Bukhari A, Shaikh A, Malik A, Alsusa H, et al. A Retrospective Two-Year Review of the Outcomes of Surgical Rib Fixation Following Chest Wall Injury by the Multidisciplinary Chest Wall Injury

Group in a Major Trauma Centre and the Change in Outcomes as the Service Has Developed. Cureus. 2023 Sep

;

Ishara Maduka AK, Lin GJ, Lim WW, Lee DJK, Kang ML, Venkatesan K, et al. A comprehensive analysis of traumatic rib fractures in an acute general hospital in Singapore. J Emerg Trauma Shock. 2019 Apr 1;12(2):145– 9.

Parra KT, Badiee J, Calvo RY, Rooney A, Krzyzaniak A, Bansal V, et al. The where, when, and why of surgical rib fixation: Utilization patterns, outcomes, and readmissions. Am J Surg. 2022 Aug 1;224(2):780–5.

Beks RB, Reetz D, de Jong MB, Groenwold RHH, Hietbrink F, Edwards MJR, et al. Rib fixation versus nonoperative treatment for flail chest and multiple rib fractures after blunt thoracic trauma: a multicenter cohort study. European Journal of Trauma and Emergency Surgery. 2019 Aug 1;45(4):655–63.

Dehghan N, Nauth A, Schemitsch E, Vicente M, Jenkinson R, Kreder H, et al. Operative vs Nonoperative Treatment of Acute Unstable Chest Wall Injuries: A Randomized Clinical Trial. JAMA Surg. 2022 Nov 9;157(11):983–90.

Jiang Y, Wang X, Teng L, Liu Y, Wang J, Zheng Z. Comparison of the effectiveness of surgical versus nonsurgical treatment for multiple rib fractures accompanied with pulmonary contusion. Annals of Thoracic and Cardiovascular Surgery. 2019;25(4):185–91.

Liu HY, Lin TH, Chen KC, Hsiao WL, Hu RH, Liao HC. Comparison between non-surgical and surgical management of rib fractures in major trauma patients without brain injuries. Am J Surg. 2023 Sep 1;226(3):350– 5.

Wijffels MME, Hagenaars T, Latifi D, Van Lieshout EMM, Verhofstad MHJ. Early results after operatively versus non-operatively treated flail chest: a retrospective study focusing on outcome and complications. European Journal of Trauma and Emergency Surgery. 2020 Jun 1;46(3):539–47.

Xiao X, Zhang S, Yang J, Wang J, Zhang Z, Chen H. Surgical fixation of rib fractures decreases intensive care length of stay in flail chest patients. Ann Transl Med. 2020 Mar;8(5):216–216.

Zhang Y, Tang X, Xie H, Wang RL. Comparison of surgical fixation and nonsurgical management of flail chest and pulmonary contusion. American Journal of Emergency Medicine. 2015 Jul 1;33(7):937–40.

Marini CP, Petrone P, Soto-Sánchez A, García-Santos E, Stoller C, Verde J. Predictors of mortality in patients with rib fractures. European Journal of Trauma and Emergency Surgery. 2021 Oct 1;47(5):1527–34.

Taghavi S, Ali A, Green E, Schmitt K, Jackson-Weaver O, Tatum D, et al. Surgical stabilization of rib fractures is associated with improved survival but increased acute respiratory distress syndrome. In: Surgery (United States). Mosby Inc.; 2021. p. 1525–31.

Cruz-De La Rosa KX, Ramos-Meléndez EO, Ruiz-Medina PE, Arrieta-Alicea A, Guerrios-Rivera L, RodríguezOrtiz P. Surgical Rib Fixation is Associated With Lower Mortality in Patients With Traumatic Rib Fractures. Journal of Surgical Research. 2024 Mar 1;295:647–54.

Ağababaoğlu I, Ersöz H. The benefits of early rib fixation for clinical outcomes of flail chest patients in intensive care unit. Turkish Journal of Thoracic and Cardiovascular Surgery. 2020;28(2):331–9.

Downloads

Published

2023-12-31

How to Cite

Atin, F., Silalahi, H. S., Prasetyanto, R. D., Desanto, F. J., & Sulisty, H. C. (2023). SURGICAL MANAGEMENT VERSUS NON-SURGICAL MANAGEMENT OF RIB FRACTURES IN CHEST TRAUMA: A SYSTEMATIC REVIEW. Journal of Advanced Research in Medical and Health Science (ISSN 2208-2425), 9(12), 247-254. https://doi.org/10.61841/smas5j15

Similar Articles

51-60 of 172

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)