None listed
Conditions
Brief summary
The optimal management of patients with fractured ribs who are not ventilator dependent has still not been determined. Although various studies suggest improvements in both short and long term function in patients who are treated by operative stabilization, there is not enough good evidence to advise management practices. However, the evidence available suggests that significant improvements in patient management and long term outcomes could be achieved by surgical fixation of ribs in these patients. A definitive answer will only be achieved by a prospective trial examining the short-term and longer term outcomes for patients treated by operative stabilization of their rib fractures This study aims to assess early and late outcomes in patients with multiple painful displaced fractured ribs with and without operative fixation.
Interventions
This study will look specifically at patients with multiple painful broken ribs and surgical fixation of displaced ribs using plates and screws as required to hold fractured ribs in the correct position to allow healing - these plates and screws remain in situ after healing. The duration of the surgery to repair the fractured ribs will depend upon the individual injury and be performed by a qualified cardiothoracic surgeon. We will compare a group treated with an operation to fix the broken ri
This study will look specifically at patients with multiple painful broken ribs and surgical fixation of displaced ribs using plates and screws as required to hold fractured ribs in the correct position to allow healing - these plates and screws remain in situ after healing. The duration of the surgery to repair the fractured ribs will depend upon the individual injury and be performed by a qualified cardiothoracic surgeon. We will compare a group treated with an operation to fix the broken ribs with plates and screws to a group treated with pain control and full supportive measures that are currently our standard of care. Study Participant's Quality of life and recovery from injury will be followed up in the months after treatment for the rib fractures.
Sponsors
Alfred Health
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
*Previously functionally independent patients with multiple, closed fractured ribs between the level of ribs 3 to 10 confirmed on CXR and CT chest. *Uncontrolled pain from fractured ribs and/ or displaced fractured ribs
Exclusion criteria
*Pre-injury dependency requiring ADL support *Invasive ventilator support at the time of referral (patients will not be excluded if they deteriorate and require invasive ventilator support after initial referral) *Spinal injuries which would preclude placement of the patient in a lateral decubitus position *Open rib fractures with soiling or infection *Severe head injury *Uncorrected coagulopathy *Adult respiratory distress syndrome *Uncorrected Sepsis *Pregnancy *Immunocompromised patients including those who are steroid dependent *Known opiate dependency *Age< 18 years or >85 years
Outcome results
None listed