Abstract
ObjectiveRib fractures are common injuries sustained by patients who experience high-impact chest trauma, and they result in severe respiratory compromise because of the altered mechanics of respiration. Several studies have shown that the ventilation requirements and incidence of pulmonary complications may be decreased with operative intervention. The purpose of this study was to evaluate the effect of surgical fixation treatments for rib fractures through systematic review and meta-analysis.MethodsA literature search was performed in the PubMed, EMBASE, Web of Science and Cochrane Library databases for information from February 1958 to April 2018. Studies comparing the benefits of surgical management with that of non-surgical management of rib fractures were included. Statistical heterogeneity was evaluated by the X2 test with the significance set to P < 0.10 or I2 > 50%.ResultsFourteen studies consisting of 839 patients were included (407 patients in the surgical management group; 432 patients in the non-surgical management group). The results showed that the surgical management group experienced a significant decrease in hospitalization time, intensive care time, mechanical ventilation time, mortality rate, pulmonary infection rate and tracheotomy rate compared with the non-surgical management group. However, the surgical management group incurred extra costs, and there was no significant difference in the duration of antibiotic use between the two groups.ConclusionsCompared with non-surgical management, surgical management methods are of great value in the treatment of rib fractures despite the added expense.
Highlights
Rib fractures are among the most common traumatic injuries and are found in 20% of all patients who suffer thoracic trauma [1]
Take home message Surgical management is more effective than non-operative management for rib fractures
The pooled results showed that the surgical management group had a lower mortality rate than the non-surgical management group, with odds ratio (OR) = 0.28; 95% confidence interval (CI), 0.08 to 0.92; P < 0.1 and without significant heterogeneity (I2 = 13%, P = 0.04) (Fig. 4)
Summary
Rib fractures are among the most common traumatic injuries and are found in 20% of all patients who suffer thoracic trauma [1]. The incidence of rib fractures in closed thoracic trauma is as high as 85%. The treatments for rib fractures are mainly divided into categories of conservative treatment and surgical treatment. Traditional conservative treatment methods include rib bone traction, pressure dressing and ventilator-assisted respiration; there are many methods for surgical treatment [3]. In this context, there is much interest in which method is of greater value in the treatment of rib fractures
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