Rib Fractures and Chest Wall Injury

Abstract

Rib fractures are one of the most common injuries found in blunt chest trauma. Rib fractures are associated with respiratory dysfunction, lung contusion, pneumonia, chronic chest wall deformities, chronic pain and diminishment in quality of life or work status. The primary goal of management is to prevent or minimize associated complications. Over the last few decades, conservative management has been considered the standard of care for rib and sternal fractures. It is postulated more recently that surgical stabilization of rib fractures (SSRF) in selected patients improves clinical outcomes. Operative and non-operative management has been studied in terms of reduction in morbidity and mortality and reduction in intensive care unit (ICU) or hospital length of stay. The literature suggests advantages of SSRF compared to conservative management for thoracic trauma, specifically flail chest, multiple displaced rib fractures, chest wall deformities, lung herniation, and chronic nonunion. Despite the literature, SSRF is not universally accepted and performed.