Surgical treatment of multiple rib fractures and flail chest in trauma: a one-year follow-up study

摘要

Background Multiple rib fractures and unstable thoracic cage injuries are common in blunt trauma. Surgical management of rib fractures has received increasing attention in recent years and the aim of this 1-year, prospective study was to assess the long-term effects of surgery. Methods Fifty-four trauma patients with median Injury Severity Score 20 (9–66) and median New Injury Severity Score 34 (16–66) who presented with multiple rib fractures and flail chest, and underwent surgical stabilization with plate fixation were recruited. Patients responded to a standardized questionnaire concerning pain, local discomfort, breathlessness and use of analgesics and health-related quality of life (EQ-5D-3?L) questionnaire at 6?weeks, 3?months, 6?months and 1?year. Lung function, breathing movements, range of motion and physical function were measured at 3?months, 6?months and 1?year. Results Symptoms associated with pain, breathlessness and use of analgesics significantly decreased from 6?weeks to 1?year following surgery. After 1?year, 13?% of patients complained of pain at rest, 47?% had local discomfort and 9?% used analgesics. The EQ-5D-3?L index increased from 0.78 to 0.93 and perceived overall health state increased from 60 to 90?% ( p Conclusions Patients with multiple rib fractures and flail chest show a gradual improvement in symptoms associated with pain, quality of life, mobility, disability and lung function over 1?year post surgery. Therefore, the final outcome of surgery cannot be assessed before 1?year post-operatively.