ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2019
Rib fixation versus non-operative treatment for flail chest and multiple rib fractures after blunt thoracic trauma: a multicenter cohort study.
Article 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. Cited by 21 papers, 3 of them syntheses that pooled 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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 46 citations in OpenAlex.
- Comparison of flail and multiple simple rib fracture patterns among patients included in rib fracture studies; A systematic review and meta-analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Pooled it
- Guideline
- How to assess applicability and methodological quality of comparative studies of operative interventions in orthopedic trauma surgery.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Pooled it
- Early surgical stabilization of rib fractures in patients with mechanical ventilation-dependent respiratory failure secondary to severe chest wall injury: a retrospective cohort study.Journal of thoracic disease · 2026Article
- Chest Wall and Diaphragmatic Injuries: Imaging Evaluation and Clinical Considerations.Journal of the Korean Society of Radiology · 2026Review
- Multivariate analysis of the effectiveness of the surgical treatment of the non-flail chest type of multiple rib fractures.Experimental and therapeutic medicine · 2025Article
- Surgical strategy for chest wall reconstruction secondary to cardiopulmonary resuscitation versus post-traumatic.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Does the treatment modality affect nosocomial pneumonia and other in-hospital outcomes in patients with combined injuries to the ribs and clavicle? A propensity score weighted analysis of a retrospective cohort.Archives of orthopaedic and trauma surgery · 2024Article
- Incidence of adult rib fracture injuries and changing hospitalization practice patterns: a 10-year analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Comparative study of wound outcomes and surgical strategies: Internal fixation versus external stabilization in rib fracture patients with traumatic chest wounds.International wound journal · 2024Article
- Watch Out for the Early Killers: Imaging Diagnosis of Thoracic Trauma.Korean journal of radiology · 2023Review
- Rib Fixation for Multiple Rib Fractures: Healthcare Professionals Perceived Barriers and Facilitators to Clinical Implementation.World journal of surgery · 2023Article
- Non-operative vs. operative treatment for multiple rib fractures after blunt thoracic trauma: a multicenter prospective cohort study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Observational
- Trends in incidence rate, health care use, and costs due to rib fractures in the Netherlands.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Rib Plating as an Effective Approach to Managing Traumatic Rib Injuries: A Review of the Literature.Cureus · 2022Review
- Effect of surgical stabilization of rib fractures in polytrauma: an analysis of the TraumaRegister DGUEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Surgical fixation of rib fractures decreases intensive care length of stay in flail chest patients.Annals of translational medicine · 2020Article
- Plate of ribs: single institution's matched comparison of patients managed operatively and non-operatively for rib fractures.Trauma surgery & acute care open · 2020Article
- Article
- Focus on rib fracture fixation after trauma.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOver the years, a trend has evolved towards operative treatment of flail chest although evidence is limited. Furthermore, little is known about operative treatment for patients with multiple rib fractures without a flail chest. The aim of this study was to compare rib fixation based on a clinical treatment algorithm with nonoperative treatment for both patients with a flail chest or multiple rib fractures.
methodsAll patients with ≥ 3 rib fractures admitted to one of the two contributing hospitals between January 2014 and January 2017 were retrospectively included in this multicenter cohort study. One hospital treated all patients nonoperatively and the other hospital treated patients with rib fixation according to a clinical treatment algorithm. Primary outcome measures were intensive care length of stay and hospital length of stay for patients with a flail chest and patients with multiple rib fractures, respectively. To control for potential confounding, propensity score matching was applied.
resultsA total of 332 patients were treated according to protocol and available for analysis. The mean age was 56 (SD 17) years old and 257 (77%) patients were male. The overall mean Injury Severity Score was 23 (SD 11) and the average number of rib fractures was 8 (SD 4). There were 92 patients with a flail chest, 37 (40%) had rib fixation and 55 (60%) had non-operative treatment. There were 240 patients with multiple rib fractures, 28 (12%) had rib fixation and 212 (88%) had non-operative treatment. For both patient groups, after propensity score matching, rib fixation was not associated with intensive care unit length of stay (for flail chest patients) nor with hospital length of stay (for multiple rib fracture patients), nor with the secondary outcome measures.
conclusionNo advantage could be demonstrated for operative fixation of rib fractures. Future studies are needed before rib fixation is embedded or abandoned in clinical practice.
Indexed as
Identifiers
What OpenQuestion holds
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.