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Article ; Online: Chest Wall Injury Society recommendation for surgical stabilization of nonunited rib fractures to decrease pain, reduce opiate use, and improve patient reported outcomes in patients with rib fracture nonunion after trauma.

Forrester, Joseph D / Bauman, Zachary M / Cole, Peter A / Edwards, John G / Knight, Ariel W / LaRoque, Michael / Raffa, Taylor / White, Thomas W / Kartiko, Susan

The journal of trauma and acute care surgery

2023  Volume 95, Issue 6, Page(s) 943–950

Abstract: Background: Rib fractures are common injuries which can be associated with acute pain and chronic disability. While most rib fractures ultimately go on to achieve bony union, a subset of patients may go on to develop non-union. Management of these ... ...

Abstract Background: Rib fractures are common injuries which can be associated with acute pain and chronic disability. While most rib fractures ultimately go on to achieve bony union, a subset of patients may go on to develop non-union. Management of these nonunited rib fractures can be challenging and variability in management exists.
Methods: The Chest Wall Injury Society's Publication Committee convened to develop recommendations for use of surgical stabilization of nonunited rib fractures (SSNURF) to treat traumatic rib fracture nonunions. PubMed, Embase, and the Cochrane database were searched for pertinent studies. Using a process of iterative consensus, all committee members voted to accept or reject the recommendation.
Results: No identified studies compared SSNURF to alternative therapy and the overall quality of the body of evidence was rated as low. Risk of bias was identified in all studies. Despite these limitations, there is lower-quality evidence suggesting that SSNURF may be beneficial for decreasing pain, reducing opiate use, and improving patient reported outcomes among patients with symptomatic rib nonunion. However, these benefits should be balanced against risk of symptomatic hardware failure and infection.
Conclusion: This guideline document summarizes the current CWIS recommendations regarding use of SSNURF for management of rib nonunion.
Level of evidence: Therapeutic/Care Management; Level IV.
MeSH term(s) Humans ; Rib Fractures/complications ; Rib Fractures/surgery ; Opiate Alkaloids ; Thoracic Wall ; Thoracic Injuries ; Ribs ; Fractures, Ununited/surgery ; Acute Pain
Chemical Substances Opiate Alkaloids
Language English
Publishing date 2023-09-19
Publishing country United States
Document type Journal Article
ZDB-ID 2651070-4
ISSN 2163-0763 ; 2163-0755
ISSN (online) 2163-0763
ISSN 2163-0755
DOI 10.1097/TA.0000000000004083
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