Multiple, simple rib fractures
Conditions
Interventions
Patients in the intervention group will be treated with open reduction and internal fixaton of fractured ribs with the Matrix Rib System. If needed, pain and inhalation medication, oxygen therapy or m
Sponsors
Erasmus MC, University Medical Center Rotterdam, Trauma Research Unit, Department of Surgery
Eligibility
Inclusion criteria
Inclusion criteria: 1. Age 18 years or older 2. For any of the ribs number 4 to 10: A) Three simple fractured ribs of which at least one dislocated over one shaft-width OR B) Three simple fractured ribs with unbearable pain (Visual Analog Scale or Numeric Rating Scale > 6 points) 3. Blunt force trauma 4. Hospital presentation within 72 hours after trauma 5. Provision of informed consent by patient or proxy
Exclusion criteria
Exclusion criteria: 1. Neurotraumatic changes leading to mechanical ventilation (GCS ¡Ü8 at 48hrs post injury. If unable to assess full GCS due to intubation or other causes, GCS motor ¡Ü 4 at 48 hours post injury) 2. Rib fractures due to cardioplulmonary resuscitation 3. Surgical rib fixation not possible due to additional traumatic injuries (hemodynamically or pulmonary unstable, for example based on parenchymal lung trauma) or patient is unfit for surgery; to be decided by an ICU-doctor, trauma surgeon, or anesthesiologist 4. Flail chest, based on radiological or clinical findings 5. Decreased sensory or motor function due to (previous) cervical or thoracic spine failure 6. Previous rib fractures or pulmonary problems, requiring continuous oxygen use at home pre-trauma 7. Congenital thoracic deformity (pectus excavatum, pectus carinatum, severe scoliosis or kyphosus) 8. Inhalation trauma or severe burns close to or inside mouth or neck 9. Surgical fixation of the ribs not feasible within seven days after trauma 10. Patients unwilling or unable to comply with the intervention or follow-up visit schedule 11. Insufficient comprehension of Dutch language to understand rehabilitation programs and other treatment information in the judgment of the attending physician 12. Participation in another surgical intervention or drug study that might influence any of the outcome parameters
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Pneumonia <30 days after trauma | — |
Secondary
| Measure | Time frame |
|---|---|
| Hospital length of stay; need and duration of mechanical ventilation; pain (Numeric Rating Scale, NRS) and analgesics use; quality of life (QoL; Euro-QoL-5D and Short Form-12); (recovery of) pulmonary function; thoracic injury-related complications and mortality; and cost effectiveness. | — |
Contacts
Public ContactM.M.E. Wijffels
P.O. Box 2040, 3000 CA Rotterdam
Outcome results
None listed