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Review
. 2022 May 16:10:100089.
doi: 10.1016/j.sipas.2022.100089. eCollection 2022 Sep.

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

Stephen Stopenski  1 , Jana Binkley  2 , Sebastian D Schubl  1 , Zachary M Bauman  2
Affiliations
Review

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

Stephen Stopenski et al. Surg Pract Sci. .

Abstract

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.

Keywords: Intercostal nerve cryoablation; Pain control; Regional analgesia; Rib fractures; Surgical stabilization of rib fractures.

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Conflict of interest statement

Dr. Stephen Stopenski, MD and Dr. Jana Binkley, MD – No financial interests/personal relationships which may be considered as potential competing interests. Dr. Sebastian Schubl is a paid education consultant for Zimmer-Biomet. Dr. Zachary Bauman is a paid educational consultant for Zimmer-Biomet, KLS-Martin, and AtriCure. None of the other authors have any relationships to disclose.

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References

    1. Kane E.D., Jeremitsky E., Pieracci F.M., Majercik S., Doben AR. Quantifying and exploring the recent national increase in surgical stabilization of rib fractures. J Trauma Acute Care Surg. 2017;83(6):1047–1052. - PubMed
    1. Bauman Z.M., Grams B., Yanala U., Shostrom V., Waibel B., Evans C.H., et al. Rib fracture displacement worsens over time. Eur J Trauma Emerg Surg. 2021;47(6):1965–1970. - PMC - PubMed
    1. Proctor H., London PS. The stove-in chest with paradoxical respiration. Br J Surg. 1955;42(176):622–633. - PubMed
    1. Coleman F.P., Coleman CL. Fracture of ribs; a logical treatment. Surgical Gynecol Obstet. 1950;90(2):129–134. - PubMed
    1. Zhang Q., Song L., Ning S., Xie H., Li N., Wang Y. Recent advances in rib fracture fixation. J Thorac Dis. 2019;11(Suppl 8):S1070–S1077. - PMC - PubMed

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