Nirula Raminder, Diaz Jose J, Trunkey Donald D, Mayberry John C
Surgery, Burns/Trauma/Critical Care Section, University of Utah, Saltlake City, UT, USA.
World J Surg. 2009 Jan;33(1):14-22. doi: 10.1007/s00268-008-9770-y.
Rib fracture repair has been performed at selected centers around the world for more than 50 years; however, the operative indications have not been established and are considered controversial. The outcome of a strictly nonoperative approach may not be optimal. Potential indications for rib fracture repair include flail chest, painful, movable rib fractures refractory to conventional pain management, chest wall deformity/defect, rib fracture nonunion, and during thoracotomy for other traumatic indication. Rib fracture repair is technically challenging secondary to the human rib's relatively thin cortex and its tendency to fracture obliquely. Nonetheless, several effective repair systems have been developed. Future directions for progress on this important surgical problem include the development of minimally invasive techniques and the conduct of multicenter, randomized trials.
全球部分中心开展肋骨骨折修复手术已有50多年；然而，手术指征尚未明确，存在争议。严格采取非手术方法的效果可能并非最佳。肋骨骨折修复的潜在指征包括连枷胸、疼痛、常规疼痛管理难以缓解的可活动肋骨骨折、胸壁畸形/缺损、肋骨骨折不愈合以及因其他创伤指征行开胸手术时。由于人类肋骨皮质相对较薄且易于斜行骨折，肋骨骨折修复在技术上具有挑战性。尽管如此，已经开发出了几种有效的修复系统。解决这一重要外科问题的未来进展方向包括微创技术的开发以及开展多中心随机试验。
