Radiographic rib fracture nonunion and association with fracture classification in adults with multiple rib fractures without flail segment: A multicenter prospective cohort study.
Chest wall injury
Chronic pain
Fracture healing
Nonunion
Thoracic trauma
Journal
Injury
ISSN: 1879-0267
Titre abrégé: Injury
Pays: Netherlands
ID NLM: 0226040
Informations de publication
Date de publication:
19 Jan 2024
19 Jan 2024
Historique:
received:
06
08
2023
revised:
01
01
2024
accepted:
14
01
2024
medline:
31
1
2024
pubmed:
31
1
2024
entrez:
30
1
2024
Statut:
aheadofprint
Résumé
Rib fracture nonunion is a probable cause of chronic pain following chest trauma, although its prevalence remains unknown. The aims of this study were to determine rib fracture nonunion prevalence following nonoperative management and to determine if presence of nonunion was associated with the number of rib fractures, or the rib fracture classification of anatomical location, type, and displacement. This multicenter prospective cohort study included trauma patients with three or more fractured ribs but without a flail segment, who participated in the nonoperative management group of the FixCon trial between January 2019 and June 2022. The number and classification of rib fractures were assessed on trauma chest CT. Chest CTs conducted six months post-trauma were evaluated for the presence of nonunion. Radiological characteristics of nonunions were compared with normally healed rib fractures using the Mann-Whitney U, χ A total of 68 patients were included with 561 post-traumatic fractures in 429 ribs. Chest CT after six months revealed nonunions in 67 (12 %) rib fractures in 29 (43 %) patients with a median of 2 (P Forty-three percent of patients with multiple rib fractures had radiographic nonunion six months after trauma. Fractures in ribs seven to 10 and dislocated fractures had an increased risk of rib fracture nonunion.
Sections du résumé
BACKGROUND
BACKGROUND
Rib fracture nonunion is a probable cause of chronic pain following chest trauma, although its prevalence remains unknown. The aims of this study were to determine rib fracture nonunion prevalence following nonoperative management and to determine if presence of nonunion was associated with the number of rib fractures, or the rib fracture classification of anatomical location, type, and displacement.
METHODS
METHODS
This multicenter prospective cohort study included trauma patients with three or more fractured ribs but without a flail segment, who participated in the nonoperative management group of the FixCon trial between January 2019 and June 2022. The number and classification of rib fractures were assessed on trauma chest CT. Chest CTs conducted six months post-trauma were evaluated for the presence of nonunion. Radiological characteristics of nonunions were compared with normally healed rib fractures using the Mann-Whitney U, χ
RESULTS
RESULTS
A total of 68 patients were included with 561 post-traumatic fractures in 429 ribs. Chest CT after six months revealed nonunions in 67 (12 %) rib fractures in 29 (43 %) patients with a median of 2 (P
CONCLUSIONS
CONCLUSIONS
Forty-three percent of patients with multiple rib fractures had radiographic nonunion six months after trauma. Fractures in ribs seven to 10 and dislocated fractures had an increased risk of rib fracture nonunion.
Identifiants
pubmed: 38290909
pii: S0020-1383(24)00026-3
doi: 10.1016/j.injury.2024.111335
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
111335Investigateurs
Taco J Blokhuis
(TJ)
Doeke Boersma
(D)
Erik R De Loos
(ER)
Elvira R Flikweert
(ER)
Frank F A IJpma
(FFA)
Sanne Kleinveld
(S)
Simon P Knops
(SP)
Albert F Pull Ter Gunne
(AF)
W Richard Spanjersberg
(WR)
Gerben Van der Bij
(G)
Floortje C Van Eijck
(FC)
Pieter J Van Huijstee
(PJ)
Gust Van Montfort
(G)
Jefrey Vermeulen
(J)
Dagmar I Vos
(DI)
Informations de copyright
Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest none.