Which is better to multiple rib fractures, surgical treatment or conservative treatment?

Abstract

To compare the surgery and conservative treatment of multiple fractured ribs, we designed a randomized controlled trial in the single center of thoracic surgery ward. After admission condition assessment (general clinical evaluation, operation condition assessment, the digital method of pain assessment), the selected multiple fractured rib patients were told to choose surgery or conservative treatment, according to the patient will undergo surgery or conservative treatment. In the acute phase, compared with conservative treatment, patients with mechanical ventilation in time (mechanical ventilation time MV) (3.7 ± 1.4 vs. 9.5 ± 4.3), ICU stay time (8.2 ± 4.3 vs. 14.6 ± 3.2), total hospitalization days (15.3 ± 6.4 vs. 26.5 ± 6.9), the incidence of pneumonia (6.7% vs. 19.1%), mortality (1.3% vs. 5.3%) and pain score on patients (3.3 vs. 5.8) of surgical treatment group were significant lower (P < 0.05). The number of tracheostomy in surgical patients with conservative treatment (4 vs. 7) was no statistically significant difference (P > 0.05). In chronic phase, the surgical patients compared with patients with conservative treatment in the chest wall pain (2.9 ± 1.2 vs. 5.6 ± 1.7), chest wall tension (13.3% vs. 57.3%), dyspnea (5.3% vs. 22.4%) and chest wall deformity rate (4% vs. 93.5%) were lower significantly (P < 0.05). In conclusion, the surgical treatment of multiple fractured ribs could ease the acute chest pain, reduce the mechanical ventilation time and incidence of pneumonia, shorten the hospitalization days and total hospitalization days in the ICU and alleviate the forward chest wall discomfort. The speedy recovery and long-term quality of patients' life had improved significantly.

Keywords: Multiple rib fractured; conservative treatment; randomized controlled trial; surgical treatment.

Figure 1

The comparison of two groups after treatment in patients with pain.