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Open Reduction and Internal Fixation of Rib Fractures in Polytrauma Patients with Flail Chest

Monday, January 4, 2016

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Author(s)

Lori DeFreest, Marcel Tafen, Avinash Bhakta, Ashar Ata, Stephen Martone, Owen Glotzer, Kevin Krautsak, Carl Rosati, Steven C. Stain, Daniel Bonville

This retrospective single-center study evaluated outcomes of patients treated for flail chest using open reduction and fixation (ORIF) or non-operative management (NOM).  The 41 ORIF and 45 NOM patients were similar in demographics and injury severity.  Hospital and ICU LOS were longer in the ORIF group.  The ORIF group also trended towards longer time on the ventilator.  Further knowledge regarding appropriate patient selection criteria for ORIF in the management of flail chest is needed.

Comments

I don't have access to the full article. How long is the average length of time before the operative group was taken to the OR for ORIF. In my experience this decision needs to be made in 1-3 days of admission to get the best benefit. If you have them on the vent for two weeks prior to deciding to operate on them of course they are going to have a longer vent course. How many of the Non ops ended up having to have tracheostomy placed to get off vent versus the Operative group?

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