ArticleSurgery2021
Surgical stabilization of rib fractures is associated with improved survival but increased acute respiratory distress syndrome.
Article in Surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 21 citations in OpenAlex.
- 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 · 2026Article
- Rare Case of Acute Pulmonary Thromboembolism After Internal Fixation of Multiple Rib Fractures.Clinical case reports · 2025Article
- Elderly Man With Blunt Chest Trauma.Journal of the American College of Emergency Physicians open · 2025Review
- Impact of Surgical Stabilization of Flail Chest Injuries on Postoperative Computed Tomography Lung Volumes.Journal of clinical medicine · 2025Article
- Long-term outcomes after removal of rib stabilization hardware in patients with blunt chest trauma.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Observational
- Age-Neutral Surgical Stabilization of Rib Fractures: Breaking the Ageism Barrier.The Journal of surgical research · 2024Article
- Conservative Treatment of Empyema Formation Following Intrathoracic Rib Fixation With Antibiotics and Tissue Plasminogen Activator/Dornase.Journal of medical cases · 2024Article
- Article
- Evaluation of surgical outcomes in elderly patients with rib fractures: A single-centre propensity score matching study.Frontiers in surgery · 2023Article
- Rib Plating as an Effective Approach to Managing Traumatic Rib Injuries: A Review of the Literature.Cureus · 2022Review
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundHow the surgical stabilization of rib fractures after trauma affects the development of acute respiratory distress syndrome and impacts survival has yet to be determined in a large database. We hypothesized that surgical stabilization of rib fractures would not decrease the incidence of acute respiratory distress syndrome.
methodsThe National Trauma Data Bank was queried for all traumatic rib fractures in 2016. Patients were divided into groups with single rib fractures, multiple rib fractures, and flail chest. Nonoperative therapy was compared with stabilization of rib fractures of 1 to 2 ribs or 3+ ribs.
resultsThere were 114,972 total patients with rib fractures meeting inclusion criteria, with 5,106 (4.4%) having flail chest, 24,726 (21.5%) having single rib fractures, and 85,140 (74.1%) having multiple rib fractures. Those with flail chest (15.9%) were most likely to get rib plating in comparison to multiple rib fractures (0.9%) and single rib fractures (0.2%); P < .001. On logistic regression, surgical stabilization of rib fractures 1 to 2 ribs (odds ratio: 0.17, 95% confidence interval: 0.10-0.28) or 3+ ribs (odds ratio: 0.17, 95% confidence interval: 0.11-0.28), with nonoperative therapy as the reference was associated with survival. Variables associated with mortality included increasing age, male sex, increasing injury severity score, decreased Glasgow coma scale, requirement of transfusions, and hypotension on admission. Surgical stabilization of rib fractures 3+ ribs (odds ratio: 2.30, 95% confidence interval: 1.58-3.37) was associated with acute respiratory distress syndrome but not 1 to 2 ribs (odd ratio: 1.55, 95% confidence interval: 0.97-2.48). On logistic regression of only patients with flail chest, stabilization of rib fractures was associated with decreased mortality but not increased risk of acute respiratory distress syndrome.
conclusionThe increased risk of acute respiratory distress syndrome should be considered in the preoperative assessment for stabilization of rib fractures.
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