Impact of rib fixation on quality of life after major trauma with multiple rib fractures

Injury. 2019 Jan;50(1):119-124. doi: 10.1016/j.injury.2018.11.005. Epub 2018 Nov 3.

Abstract

Introduction: Multiple rib fractures have been shown to reduce quality of life both in the short and long term. Treatment of rib fractures with operative fixation reduces ventilator requirements, intensive care unit stay, and pulmonary complications in flail chest patients but has not been shown to improve quality of life in comparative studies to date. We therefore wanted to analyse a large cohort of multiple fractured rib trauma patients to see if rib fixation improved their quality of life.

Methods: Retrospective review (January 2012 - April 2015) of prospectively collected data on 1482 consecutive major trauma patients admitted to The Alfred Hospital with rib fractures. The main outcome measures were Quality of Life over 24 months post injury assessed using the Glasgow Outcome Scale Extended (GOSErate) and Short Form (SF12) health assessment forms and a pain questionnaire.

Results: 67 (4.5%) patients underwent rib fixation and were older, with a higher incidence of flail chest injury, and higher AIS and ISS scores than the remainder of the cohort. Rib fixation provided no benefit in pain, SF-12 or GOSErate scores over 24 months post injury.

Conclusions: This study has not been able to demonstrate any quality of life benefit of rib fixation over 24 months post injury in patients with major trauma.

Keywords: Flail chest; Quality of life; Rib fracture; Surgical rib fixation.

MeSH terms

  • Adult
  • Aged
  • Analgesia / statistics & numerical data
  • Australia
  • Female
  • Flail Chest / physiopathology
  • Flail Chest / psychology*
  • Flail Chest / surgery
  • Fracture Fixation, Internal
  • Fracture Healing / physiology
  • Humans
  • Intensive Care Units
  • Length of Stay / statistics & numerical data*
  • Male
  • Middle Aged
  • Pain / psychology*
  • Quality of Life / psychology*
  • Respiration, Artificial
  • Retrospective Studies
  • Rib Fractures / complications
  • Rib Fractures / physiopathology
  • Rib Fractures / psychology*
  • Rib Fractures / surgery
  • Surveys and Questionnaires
  • Thoracic Injuries / complications
  • Thoracic Injuries / physiopathology
  • Thoracic Injuries / psychology*
  • Thoracic Injuries / surgery
  • Time Factors
  • Young Adult