SynthesisWorld journal of emergency surgery : WJES2024
A meta-analysis and trial sequential analysis of randomised controlled trials comparing nonoperative and operative management of chest trauma with multiple rib fractures.
Synthesis in World journal of emergency surgery : WJES, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
What it found
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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.
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Who cites it
20 citing papers in PubMed, 20 citations in OpenAlex.
- Thoracoscopic internal fixation, open surgical internal fixation, and conservative treatment of rib fractures: differences in postoperative rehabilitation and chest volume (a randomized controlled trial).European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Trial
- 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 · 2026Review
- Surgical stabilization of rib fractures is associated with lower adjusted odds of adverse pulmonary outcomes across RibScore-defined injury severity: a single-center cohort study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- An interpretable early intensive care unit model for predicting in-hospital mortality in trauma patients combined with rib fractures: development and external validation.Journal of thoracic disease · 2026Article
- An Overview of Meta-Analyses on the Surgical Stabilization of Rib Fractures in Adults: A Narrative Umbrella Review (2020-2025).Journal of clinical medicine · 2026Review
- Application of virtual overlapping technology for the selection of appropriate metal plate dimensions in rib fracture surgery.Quantitative imaging in medicine and surgery · 2026Article
- Quality of rib fracture-related video information on TikTok and Bilibili: a cross-sectional study.Journal of thoracic disease · 2026Article
- Clinical value of surgical intervention and decision-making dilemmas for elderly patients of rib fractures: a systematic review and meta-analysis.Journal of thoracic disease · 2026Article
- "Anchor-type" incision for surgical stabilization of anterior rib fractures: a single center experience and evaluation.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Directed acoustic shadow enhancement for pre-incision ultrasound localization and precise incision planning in multiple rib fractures undergoing SSRF: a retrospective comparative feasibility study.Frontiers in medicine · 2026Article
- From empirical practice to precision medicine: developing a methodology for adjusting traditional Chinese medicine formula dosages based on eight multicenter clinical studies.Frontiers in pharmacology · 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
- Surgical stabilization of rib fractures improves survival in functionally dependent trauma patients.World journal of emergency surgery : WJES · 2025Article
- Lateral Cortical Fixation as the Optimal Strategy for Achieving Stability in Rib Fractures: A Patient-Specific Finite Element Analysis.Bioengineering (Basel, Switzerland) · 2025Article
- Post-discharge complications and follow-up timing after hospitalization for traumatic rib fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Outcomes of internal rib fixation through complete video-assisted thoracoscopic surgery for multiple rib fractures and flail chest in severe chest trauma.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Clinical application of a novel rib fracture score system in patients with multiple rib fractures.Frontiers in surgery · 2025Article
- Article
- Ultra minimally invasive surgical stabilization of Rib fractures (uMI-SSRF): reduction and fixation techniques to minimize the surgical wound.World journal of emergency surgery : WJES · 2024Article
- Fracture Mapping in High-Energy Chest Trauma.Journal of clinical medicine · 2024Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOperative treatment of traumatic rib fractures for better outcomes remains under debate. Surgical stabilization of rib fractures has dramatically increased in the last decade. This study aimed to perform a systematic review and meta-analysis of randomised controlled trials (RCTs) to assess the effectiveness and safety of operative treatment compared to conservative treatment in adult patients with traumatic multiple rib fractures.
methodsA systematic literature review was performed according to the preferred reporting items for systematic reviews and meta-analyses guidelines. We searched MEDLINE, Scopus, and Cochrane Central Register of Controlled Trials and used the Cochrane Risk-of-Bias 2 tool to evaluate methodological quality. Relative risks with 95% confidence interval (CI) were calculated for outcomes: all-cause mortality, pneumonia incidence, and number of mechanical ventilation days. Overall certainty of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, with trial sequential analysis performed to establish implications for further research.
resultsFrom 719 records, we included nine RCTs, which recruited 862 patients. Patients were assigned to the operative group (received surgical stabilization of chest wall injury, n = 423) or control group (n = 439). All-cause mortality was not significantly different (RR = 0.53; 95% CI 0.21 to 1.38, P = 0.35, I
conclusionMeta-analysis of large-scale trials showed that surgical stabilization of multiple rib fractures shortened the duration of mechanical ventilation and reduced the incidence of pneumonia but lacked clear evidence for improvement of mortality compared to conservative treatment. Trial sequential analysis suggested the need for more cases, and GRADE highlighted low certainty, emphasizing the necessity for further targeted RCTs, especially in mechanically ventilated patients. SYSTEMATIC REVIEW REGISTRATION: UMIN Clinical Trials Registry UMIN000049365.
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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.