Retrospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2019; 7(22): 3718-3727
Published online Nov 26, 2019. doi: 10.12998/wjcc.v7.i22.3718
Surgical treatment ofpatients with severe non-flail chest rib fractures
Jian-Peng Zhang, Lin Sun, Wei-Qiang Li, Yan-Yu Wang, Xin-Zhen Li, Yang Liu
Jian-Peng Zhang, Lin Sun, Wei-Qiang Li, Yan-Yu Wang, Xin-Zhen Li, Yang Liu, Department of Thoracic Surgery, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, China
Author contributions: Zhang JP and Sun L designed the research; Zhang JP, Li WQ, Wang YY, and Li XZ performed the research; Liu Y and Sun L analyzed the data and wrote the paper.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Beijing Luhe Hospital, Capital Medical University (No. 2019-LHKY-007-02).
Informed consent statement: Written informed consent was obtained from the patients.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article are reported.
Data sharing statement: No additional data available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Lin Sun, MD, Professor, Department of Thoracic Surgery, Beijing Luhe Hospital, Capital Medical University, No. 82, Xinhua South Road, Tongzhou District, Beijing 101100, China. lhyyxwk19@163.com
Telephone: +86-10-69543901Fax: +86-10-69543901
Received: August 21, 2019
Peer-review started: August 21, 2019
First decision: September 9, 2019
Revised: October 8, 2019
Accepted: October 15, 2019
Article in press: October 15, 2019
Published online: November 26, 2019
Processing time: 96 Days and 7.6 Hours
Abstract
BACKGROUND

Many patients have inadequate long-term analgesia, respiratory distress, and hypoxemia due to a long-standing substantial smoking history or the presence of primary pulmonary diseases; analgesic treatment is not valid in these patients. Even if the imaging findings of rib fractures are relatively mild, rib fractures may cause severe position limitation, respiratory distress, and hypoxemia.

AIM

To investigate the curative effect of surgical treatment for patients with severe non-flail chest rib fractures.

METHODS

A total of 78 patients from our hospital with severe noncontinuous thoracic rib fractures from September 2016 to September 2018 were enrolled in our study. Thirty-nine patients underwent surgical treatment, and 39 underwent conservative treatment. The surgical treatment group received surgery performed with titanium plates, and the screws were inserted with open reduction and internal fixation. The conservative treatment group received analgesia and symptomatic treatment. The pain scores at 72 h, 1 wk, 2 wk, 4 wk, 6 wk, 3 mo, and 6 mo were compared, and the SF-36 quality of life scores were compared atthe 3rd and 6th months.

RESULTS

Pain relief in the surgical group was significantly better than that in the conservative group at each time point (72 h, 1 wk, 2 wk, 4 wk, 6 wk, 3 mo, and 6 mo after surgery, P < 0.001). ( The SF-36 scores were significantly higher in the surgical group than in the conservative group at 1 mo and 6 mo (P < 0.05).

CONCLUSION

Patients with severe non-flail chest rib fractures have a better quality of life following surgical treatment than following conservative treatment, and surgical treatment is also useful for relieving pain. We should pay more attention to the physiological functions and clinical manifestations of patients with severe rib fractures. In patients with non-flail chest rib fractures, surgical treatment is feasible and effective.

Keywords: Severe; Non-flail chest rib fractures; Treatment; Conservative surgery; Internal fixation; Quality of life

Core tip: Patients with severe non-flail chest rib fractures have a better quality of life following surgical treatment than following conservative treatment, and surgical treatment is also useful for relieving pain. We should pay more attention to the physiological functions and clinical manifestations of patients with severe rib fractures. In patients with non-flail chest rib fractures, surgical treatment is feasible and effective.