Observational studyEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2023
Non-operative vs. operative treatment for multiple rib fractures after blunt thoracic trauma: a multicenter prospective cohort study.
Observational study in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 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
19 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- 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
- Preventing confounding in observational studies in orthopedic trauma surgery through expert panels: a systematic review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Pooled it
- Surgical stabilization of rib fractures in adults without flail chest: a scoping review of pain, quality of life, and clinical outcomes.Journal of thoracic disease · 2026Review
- Impact of inflammatory biomarkers and surgical interventions on one-month recovery after rib fractures: a propensity-matched cohort study.BMC surgery · 2026Article
- Long-term quality of life and chronic pain after surgical vs. non-operative treatment of rib fractures: systematic review and meta-analysis.Frontiers in surgery · 2026Review
- Impact of inflammatory biomarkers and surgical interventions on one-month recovery after rib fractures: A propensity-matched cohort study.Surgery open science · 2025Review
- Demographics, treatment, and outcomes of rib fractures in older adults: a retrospective multi-institutional study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Implant irritation and removal rates in operatively treated multiple rib fractures: a 49-month follow-up study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Observational
- 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
- Surgical stabilization of rib fractures (SSRF): the WSES and CWIS position paper.World journal of emergency surgery : WJES · 2024Review
- Routine 6-Week Outpatient Radiography and Visit in Patients with Conservatively Treated Multiple Rib Fractures: Valuable or a Waste of Resources?Journal of chest surgery · 2024Article
- Minimally Invasive Surgical Management of Chronic Cough-Induced Rib Fracture Non-Union: A Case Report.The American journal of case reports · 2024Article
- Natural Experiments as a Study Method in Spinal Trauma Surgery: A Systematic Review.Global spine journal · 2024Review
- Article
- Door to door in 24: factors that allow surgical stabilization of rib fractures within 24 hours of admission.Journal of thoracic disease · 2023Article
- Surgical stabilization of multiple rib fractures in an Asian population: a systematic review and meta-analysis.Journal of thoracic disease · 2023Article
- Quality of life and clinical outcomes of operatively treated patients with flail chest injuries: A multicentre prospective cohort study.Frontiers in surgery · 2023Article
- Editor's Spotlight/Take 5: Functional Outcome After Nonoperative Management of Tibial Plateau Fractures in Skeletally Mature Patients: What Sizes of Gaps and Stepoffs Can be Accepted?Clinical orthopaedics and related research · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors.
Funding
Abstract
backgroundPatients with multiple rib fractures without a clinical flail chest are increasingly being treated with rib fixation; however, high-quality evidence to support this development is lacking.
methodsWe conducted a prospective multicenter observational study comparing rib fixation to non-operative treatment in all patients aged 18 years and older with computed tomography confirmed multiple rib fractures without a clinical flail chest. Three centers performed rib fixation as standard of care. For adequate comparison, the other three centers performed only non-operative treatment. As such clinical equipoise formed the basis for the comparison in this study. Patients were matched using propensity score matching.
resultsIn total 927 patients with multiple rib fractures were included. In the three hospitals that performed rib fixation, 80 (14%) out of 591 patients underwent rib fixation. From the nonoperative centers, on average 71 patients were adequately matched to 71 rib fixation patients after propensity score matching. Rib fixation was associated with an increase in hospital length of stay (HLOS) of 4.9 days (95%CI 0.8-9.1, p = 0.02) and a decrease in quality of life (QoL) measured by the EQ5D questionnaire at 1 year of 0.1 (95% CI - 0.2-0.0, p = 0.035) compared to non-operative treatment. A subgroup analysis of patients who received operative care within 72 h showed a similar decrease in QoL. Up to 22 patients (28%) who underwent surgery experienced implant-related irritation.
conclusionsWe found no benefits and only detrimental effects associated with rib fixation. Based on these results, we do not recommend rib fixation as the standard of care for patients with multiple rib fractures.
trial registrationRegistered in the Netherlands Trial Register NTR6833 on 13/11/2017.
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.