Rib fracture management: A review of surgical stabilization, regional analgesia, and intercostal nerve cryoablation

Abstract

• Rib fractures (RF) are common and result in significant morbidity and mortality. • Surgical stabilization of rib fractures (SSRF) has shown to improve outcomes. • SSRF indications include flail chest, ≥ 3 severely displaced RF, and the elderly. • New regional analgesia has improved outcomes and decreased narcotic requirements. • Intercostal nerve cryoablation is safe and effective pain reducing adjunct to SSRF. Rib fractures still remain a common problem in blunt thoracic trauma, often resulting significant acute and/or chronic morbidity and mortality. The management of rib fractures has improved over the past two decades, resulting in overall improved patient outcomes. With advances in surgical stabilization of rib fractures (SSRF), improvements in regional analgesia, and the introduction of intercostal nerve cryoablation, patient outcomes from rib fractures have improved significantly over the past several years. This article explores the indications and technique for SSRF as well as discusses additional therapeutic modalities for rib fractures through regional anesthesia and intercostal nerve cryoablation.