gms | German Medical Science

German Congress of Orthopaedics and Traumatology (DKOU 2021)

26. - 29.10.2021, Berlin

Outcome after surgical stabilization of rib fracture non-union – a retrospective case series

Meeting Abstract

  • presenting/speaker Suzanne van Wijck - Erasmus MC, Rotterdam, Netherlands
  • Esther van Lieshout - Erasmus MC, Rotterdam, Netherlands
  • Jonne Prins - Erasmus MC, Rotterdam, Netherlands
  • Pieter van Huijstee - HagaZiekenhuis, s-Gravenhage, Netherlands
  • Jefrey Vermeulen - Maasstad Ziekenhuis, Rotterdam, Netherlands
  • Mathieu Wijffels - Erasmus MC, Rotterdam, Netherlands

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2021). Berlin, 26.-29.10.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocAB91-1268

doi: 10.3205/21dkou634, urn:nbn:de:0183-21dkou6348

Published: October 26, 2021

© 2021 van Wijck et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives: This study aimed to determine the long-term level of pain after surgical treatment of one or more symptomatic rib fracture non-unions. Secondary aims were to evaluate the occurrence of complications, patient satisfaction with functional results, and work resumption.

Methods: This multicenter retrospective cohort study included adult patients operated for a symptomatic rib fracture non-union with a minimum follow-up of three months. Symptomatic non-union was defined as a persistent localized pain associated with non-bridging callus of one or more rib fractures on a chest CT scan at least three months after the initial trauma. Patients were invited to complete questionnaires about their pain, satisfaction with the functional result, and activity resumption. Complications were retrieved from the patient's medical files.

Results and Conclusion: Twenty-two patients (17 men, 5 women), with a median age of 56 years (P25-P75 50-62) and a total of 67 fractured ribs were included. Non-union occurred in 49 (73%) fractured ribs of which 40 (82%) were treated surgically. The median time between injury and non-union surgery was 14 months (P25-P75 9-30). Before surgery, 4 patients (18%) had moderate pain, 16 patients (73%) suffered from severe pain. At the follow-up visit (median 9 months (P25-P75 5-27) after surgery), 4 (18%) and 8 (36%) patients reported moderate or severe pain, respectively. Eighteen patients had complications, for which eight patients underwent additional surgery. The majority of patients (n=17; 77%) were very satisfied with their functional recovery. Nine patients (41%) had resumed their work at least partially.

In conclusion, surgical treatment of rib fracture non-unions can provide alleviation of pain in a significant number of patients and is associated with high patient satisfaction. Nevertheless, persistent pain and surgery-related complications are common.