From the Center for Trauma and Critical Care, Department of Surgery (B.S.), George Washington University, Washington, DC; and Department of Surgery (F.P.), Denver Health Medical Center, Denver, Colorado.
J Trauma Acute Care Surg. 2024 Sep 1;97(3):337-342. doi: 10.1097/TA.0000000000004338. Epub 2024 Mar 29.
Ten percent of all injured patients and 55% of patients with blunt chest trauma experience rib fractures. The incidence of death due to rib fractures is related to the number of fractured ribs, severity of fractured ribs, and patient age and comorbid conditions. Death due to rib fracture is mostly caused by pneumonia because of inability to expectorate and take deep breaths. Over the last 25 to 30 years, there has been renewed interest in surgical stabilization of rib fractures (SSRF), known colloquially as "rib plating." This review will present what you need to know in regard to triage decisions on whether to admit a patient to the hospital, the location to which they should be admitted, criteria and evidentiary support for SSRF, timing to SSRF, and operative technique. The review also addresses the cost-effectiveness of this operation and stresses nonoperative treatment modalities that should be implemented prior to operation.
10%的受伤患者和 55%的钝性胸部创伤患者会发生肋骨骨折。肋骨骨折导致的死亡率与骨折肋骨的数量、骨折肋骨的严重程度以及患者年龄和合并症有关。肋骨骨折导致的死亡主要是由于无法咳痰和深呼吸导致的肺炎引起的。在过去 25 到 30 年中,人们对肋骨骨折的手术固定(SSRF)重新产生了兴趣,俗称“肋骨板”。本综述将介绍在是否需要将患者住院、应住院的地点、SSRF 的标准和证据支持、SSRF 的时机以及手术技术方面进行分诊决策所需了解的内容。本综述还讨论了该手术的成本效益,并强调了在手术前应实施的非手术治疗方法。