Author:
Forrester Joseph D.,Bauman Zachary M.,Cole Peter A.,Edwards John G.,Knight Ariel W.,LaRoque Michael,Raffa Taylor,White Thomas W.,Kartiko Susan
Abstract
BACKGROUND
Rib fractures are common injuries which can be associated with acute pain and chronic disability. While most rib fractures ultimately go on to achieve bony union, a subset of patients may go on to develop non-union. Management of these nonunited rib fractures can be challenging and variability in management exists.
METHODS
The Chest Wall Injury Society’s Publication Committee convened to develop recommendations for use of surgical stabilization of nonunited rib fractures (SSNURF) to treat traumatic rib fracture nonunions. PubMed, Embase, and the Cochrane database were searched for pertinent studies. Using a process of iterative consensus, all committee members voted to accept or reject the recommendation.
RESULTS
No identified studies compared SSNURF to alternative therapy and the overall quality of the body of evidence was rated as low. Risk of bias was identified in all studies. Despite these limitations, there is lower-quality evidence suggesting that SSNURF may be beneficial for decreasing pain, reducing opiate use, and improving patient reported outcomes among patients with symptomatic rib nonunion. However, these benefits should be balanced against risk of symptomatic hardware failure and infection.
CONCLUSION
This guideline document summarizes the current CWIS recommendations regarding use of SSNURF for management of rib nonunion.
LEVEL OF EVIDENCE
Therapeutic/Care Management; Level IV.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Critical Care and Intensive Care Medicine,Surgery
Cited by
3 articles.
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