Rib Fractures
Conditions
Keywords
surgical stabilization, conservative treatment
Brief summary
The purpose of this research is to compare the outcomes of surgical stabilization and conservative treatment in patients with isolated minor rib fractures.
Detailed description
Isolated minor rib fractures (IMRFs), which is defined by single or two isolated minor rib fractures caused by trauma or stress. Traditionally, rib fractures are managed mainly by surgical stabilization or conservative treatment. In 2018, a systemic review and meta-analysis for patients with multiple rib fractures had revealed a shorter duration of mechanical ventilation, shorter hospital length of stay, and fewer trauma-associated complications in the surgical group than in the non-surgical group. In contrast, IMRFs are seldom life threatening, and compared to extremity fractures, rib fractures do not require matching accurately. Thus, IMRFs are usually treated conservatively. However, the investigators have clinically observed that patients suffering severe pain due to progressive rib displacement may take longer to return to normal activity, have lower quality of life, and even an increased risk of complications. Moreover, limited studies discussed the efficacy of surgical interventions for IMRFs. Therefore, the investigators conduct a prospective observational cohort study to compare the outcomes of surgical stabilization and conservative treatment in patients with IMRFs. The investigators collect patients with IMRFs whose situation were both suitable for surgical and non-surgical interventions. After explanation, patients can decide to undergo conservative or surgical treatment by themselves. The investigators will follow up pain scores, chest X-ray, pulmonary function tests, and duration of return to normal activity. Those data will be statistically analyzed by two-tailed two-sample t-test. This prospective cohort study is supposed to provide more evidence for clinical decision making and optimal management of IMRFs.
Interventions
PROCEDUREOpen reduction and internal fixation
Open reduction and internal fixation
Sponsors
Taipei Medical University Shuang Ho Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
20 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* Patient age ≥ 20 years old. * Patient was diagnosed with isolated minor rib fractures by thoracic surgeon. * Patient was suitable for both surgical stabilization and conservative treatment.
Exclusion criteria
* Severe trauma associated to other systems. * Pathologic fractures: such as fracture due to metastasis or steroid therapy. * Unconsciousness or disturbed conscious level.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Duration of return to normal activity | 3 months after operation or after injury | From day of injury to day of return to normal activity |
| Pain score change at 1 week | Change from injury or operation at 1 week | Pain Visual analog scales (Pain VAS) to measure pain intensity. A 10 cm horizontal line will be shown and patients mark on the line representing their perception of their current state. The score range from 0 to 10, with following cutpoints: no pain (0 cm), mild pain(1-4 cm), moderate pain (5-7 cm), and severe pain (8-10 cm). |
| Pain score change at 3 months | Change from injury or operation at 3 months | Pain Visual analog scales (Pain VAS) to measure pain intensity. A 10 cm horizontal line will be shown and patients mark on the line representing their perception of their current state. The score range from 0 to 10, with following cutpoints: no pain (0 cm), mild pain(1-4 cm), moderate pain (5-7 cm), and severe pain (8-10 cm). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Peak expiratory flow (PEF) change | Change from injury or operation at 3 months | Pulmonary function testing with spirometry, in unit of liters per minute |
| Forced vital capacity (FVC) change | Change from injury or operation at 3 months | Pulmonary function testing with spirometry, using percent of the predicted value (%) |
| 36-Item Short Form Survey (SF-36) results | At 3 months after injury or operation | Quality of life will be evaluated via SF-36 questionnaire, and will be scored according to SF-36 scoring rules |
| Forced expiratory volume in the first second (FEV1) change | Change from injury or operation at 3 months | Pulmonary function testing with spirometry, using percent of the predicted value (%) |
| Total lung capacity (TLC) change | Change from injury or operation at 3 months | Pulmonary function testing with spirometry, using percent of the predicted value (%) |
Contacts
Primary ContactTung-Yu Tiong, MD
Outcome results
None listed