Evidence map›Paper›PMID 30276722›Full record

SynthesisEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2019

Fixation of flail chest or multiple rib fractures: current evidence and how to proceed. A systematic review and meta-analysis.

Reinier B Beks, Jesse Peek, Mirjam B de Jong, Karlijn J P Wessem, Cumhur F Öner, Falco Hietbrink, Luke P H Leenen, Rolf H H Groenwold, Roderick M Houwert

Registry-linked trialOpen access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05975762 (Outcome of Surgical Fixation of Multiple Fractured Ribs at Sohag University Hospital), which is not on this map. Cited by 59 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
59citing papers in PubMed, 9 pooled it
11.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05975762 naunknown statusnot on this mapstarted 2023, after this paper: background citation

Outcome of Surgical Fixation of Multiple Fractured Ribs at Sohag University Hospital

TypeinterventionalSponsorSohag UniversityRan2023 to 2024Enrolled60ConditionsMultiple Fractures of RibsArmssurgical rib fixation
3 · Its place in the literature

Who cites it

59 citing papers in PubMed, 9 syntheses or guidelines pooled it, 143 citations in OpenAlex.

  1. Pooled it
  2. Effects of reduction technique for acute anterior shoulder dislocation without sedation or intra-articular pain management: a systematic review and meta-analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023
    Pooled it
  3. Rib fractures in the elderly population: a systematic review.Archives of orthopaedic and trauma surgery · 2023
    Pooled it
  4. Epidemiology of combined clavicle and rib fractures: a systematic review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022
    Pooled it
  5. Open plate fixation versus nailing for humeral shaft fractures: a meta-analysis and systematic review of randomised clinical trials and observational studies.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022
    Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. From rib fixation to dynamic chest wall reconstruction: historical lessons for modern surgical stabilization of rib fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026
    Review
  11. Rib Plating Versus Nonsurgical Treatment of Flail Chest: Comparison of Adverse Events in More than 12,500 Patients.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2026
    Article
  12. Article
  13. Review
  14. Article
  15. Review
  16. Article
  17. Article
  18. Article
  19. Surgical rib fixation in patients with cardiopulmonary disease improves outcomes.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025
    Article
  20. Costal fracture assessment for relief and enhancement of quality of life-CARE study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025
    Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Reinier B BeksDepartment of Surgery, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands. reinierbeks@gmail.com.
Jesse PeekDepartment of Surgery, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
Mirjam B de JongDepartment of Surgery, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
Karlijn J P WessemDepartment of Surgery, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
Cumhur F ÖnerDepartment of Surgery, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
Falco HietbrinkDepartment of Surgery, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
Luke P H LeenenDepartment of Surgery, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
Rolf H H GroenwoldJulius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht, The Netherlands.
Roderick M HouwertDepartment of Surgery, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
University Medical Center Utrecht · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe aim of this systematic review and meta-analysis was to present current evidence on rib fixation and to compare effect estimates obtained from randomized controlled trials (RCTs) and observational studies.

methodsMEDLINE, Embase, CENTRAL, and CINAHL were searched on June 16th 2017 for both RCTs and observational studies comparing rib fixation versus nonoperative treatment. The MINORS criteria were used to assess study quality. Where possible, data were pooled using random effects meta-analysis. The primary outcome measure was mortality. Secondary outcome measures were hospital length of stay (HLOS), intensive care unit length of stay (ILOS), duration of mechanical ventilation (DMV), pneumonia, and tracheostomy.

resultsThirty-three studies were included resulting in 5874 patients with flail chest or multiple rib fractures: 1255 received rib fixation and 4619 nonoperative treatment. Rib fixation for flail chest reduced mortality compared to nonoperative treatment with a risk ratio of 0.41 (95% CI 0.27, 0.61, p < 0.001, I

conclusionsRib fixation for flail chest improves short-term outcome, although the indication and patient subgroup who would benefit most remain unclear. There is insufficient data regarding treatment for multiple rib fractures. Observational studies show similar results compared with RCTs.

Indexed as

AgedConservative TreatmentCritical CareFemaleFlail ChestFracture FixationHumansLength of StayMaleMiddle AgedObservational Studies as TopicPneumoniaRandomized Controlled Trials as TopicRespiration, ArtificialRib FracturesTracheostomyCurrent evidenceFlail chestMultiple rib fracturesNonoperative treatmentOperative treatment

Identifiers

PMID30276722
PMCPMC6689030
OpenAlexW2894648628

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.