A Comprehensive Review of the Non-operative Management of Traumatic Rib Fractures

Abstract

Abstract Purpose of Review This review summarizes current literature on the non-operative management of traumatic rib fractures, including risk assessment scores, respiratory therapy, and multimodal and regional analgesia. Recent Findings Rib fractures are associated with significant morbidity and mortality, especially in elderly patients. Risk assessment scores, such as the Pain Inspiration Cough (PIC) score, allow for early identification and dynamic assessment of those at risk for ICU admission or increased length of stay. Incentive spirometry is both prognostic and therapeutic for patients with rib fractures, while high flow nasal cannula and non-invasive ventilation strategies lack robust evidence. Multimodal analgesia regimens have been associated with significant reductions in opioid exposure and pain scores. Epidural and regional anesthesia remain common analgesic modalities to decrease unplanned intubation and ICU admission especially in elderly patients. Summary Optimizing pulmonary hygiene and analgesia regimens remain the primary evidence-based goals of management for patients with rib fractures.