Rib fractures in trauma patients: does operative fixation improve outcome?
Curr Opin Crit Care
; 22(6): 572-577, 2016 12.
Article
em En
| MEDLINE
| ID: mdl-27811559
ABSTRACT
PURPOSE OF REVIEW Renewed interest in surgical fixation of rib fractures has emerged. However, conservative treatment is still preferred at most surgical departments. We wanted to evaluate whether operative treatment of rib fractures may benefit severely injured patients. RECENT FINDINGS:
Several studies report a reduction in mechanical ventilation time, ICU length of stay (LOS), hospital LOS, pneumonia, need for tracheostomy, pain and costs in operatively treated patients with multiple rib fractures compared with patients treated nonoperatively. Although patient selection and timing of the operation seem crucial for successful outcome, no consensus exists. Mortality reduction has only been shown in a few studies. Most studies are retrospective cohort and case-control studies. Only four randomized control trials exist.SUMMARY:
Conservative treatment, consisting of respiratory assistance and pain control, is still the treatment of choice in the vast majority of patients with multiple rib fractures. In selected patients, operative fixation of fractured ribs within 72âh postinjury may lead to better outcome. More randomized control trials are needed to further determine who benefits from surgical fixation of rib fractures.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fraturas das Costelas
/
Ensaios Clínicos Controlados Aleatórios como Assunto
/
Tórax Fundido
/
Fixação Interna de Fraturas
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article