Evaluation of the medium-term outcomes in the treatment of severe multiple rib fractures in blunt chest trauma

Abstract

Subjects and method: A total of 164 patients were diagnosed with blunt thoracic trauma (BTT) associated with rib fractures between October 2020 and October 2023 at Viet Duc Friendship Hospital, Cho Ray Hospital, and Viet Tiep Friendship Hospital. The study population was divided into two groups: Group 1: Patients with BTT who underwent rib fixation surgery using plates and screws. Group 2: Patients with BTT who did not undergo rib fixation surgery (conservative treatment). This is a multicenter descriptive study with longitudinal follow-up, including a non-randomized control group.

Results: More than 3/4 of patients were male (75.6%). The main cause of injury in the study was traffic accidents, accounting for 65.9%. The average VAS score 1 month after surgery was 0.83 in the group with surgical stabilization of rib fractures by plates and screws, while in the conservative treatment group it was 1.47 points (p < 0.05). After 3 months, complications of hemothorax occurred in the conservative treatment group with 3.1%, only 1 patient in the group with surgical stabilization of rib fractures by plates and screws had hemothorax accounting for 1.6%. However, the above difference was not statistically significant. The total quality of life score in the group with surgical stabilization of rib fractures by plates and screws after 1 month was on average 0.7 points, after 3 months was 0.95 points. However, in the conservative treatment group, the increase was not high, after 1 month was 0.62 points, after 3 months was 0.77 points (p < 0.01).

Conclusion: The surgical stabilization of rib fractures by plates and screws is effective for mid-term results with low complication rates, improving quality of life and effectively reducing pain in patients with blunt chest trauma.