Surgical management versus non-surgical management of rib fractures in chest trauma:a systematic review and meta-analysi
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(2019) 14:45
RESEARCH ARTICLE
Open Access
Surgical management versus non-surgical management of rib fractures in chest trauma:a systematic review and metaanalysis Xin Liu1* and Kai Xiong2
Abstract Objective: Rib fractures are common injuries sustained by patients who experience high-impact chest trauma, and they result in severe respiratory compromise because of the altered mechanics of respiration. Several studies have shown that the ventilation requirements and incidence of pulmonary complications may be decreased with operative intervention. The purpose of this study was to evaluate the effect of surgical fixation treatments for rib fractures through systematic review and meta-analysis. Methods: A literature search was performed in the PubMed, EMBASE, Web of Science and Cochrane Library databases for information from February 1958 to April 2018. Studies comparing the benefits of surgical management with that of non-surgical management of rib fractures were included. Statistical heterogeneity was evaluated by the X2 test with the significance set to P < 0.10 or I2 > 50%. Results: Fourteen studies consisting of 839 patients were included (407 patients in the surgical management group; 432 patients in the non-surgical management group). The results showed that the surgical management group experienced a significant decrease in hospitalization time, intensive care time, mechanical ventilation time, mortality rate, pulmonary infection rate and tracheotomy rate compared with the non-surgical management group. However, the surgical management group incurred extra costs, and there was no significant difference in the duration of antibiotic use between the two groups. Conclusions: Compared with non-surgical management, surgical management methods are of great value in the treatment of rib fractures despite the added expense. Keywords: Rib fractures, Surgical management, Non-surgical management, Complication, Meta-analysis
Key question Compare and analyse the recovery rate and rate of complications of rib fractures managed with surgical and non-surgical treatments. Key findings Surgical management will provide more benefits for patients with rib fractures. * Correspondence: [email protected] 1 The Second Hospital of TianJin Medical University, Ping Jiang Road No.23, Hexi District, Tianjin 300211, China Full list of author information is available at the end of the article
Take home message Surgical management is more effective than non-operative management for rib fractures. Introduction Rib fractures are among the most common traumatic injuries and are found in 20% of all patients who suffer thoracic trauma [1]. Rib fractures are responsible for significant loss of work days and can affect patients for several months after the injury. The incidence of rib fractures in closed thoracic trauma is as high as 85%. Common causes of injury include road traffic accidents, high falls, indirect crush forces, and direct violence. Rib
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