Clinical management of rib fractures and methods for prevention of pulmonary complications: A review

• Published in: Injury 2019-06, Vol.50 (6), p.1159-1165
• Main Authors: Martin, Thomas J., Eltorai, Ashley Szabo, Dunn, Ryan, Varone, Andrew, Joyce, Maurice F., Kheirbek, Tareq, Adams, Charles, Daniels, Alan H., Eltorai, Adam E.M.
• Format: Article
• Language: English
• Subjects: Chest trauma; Fracture Fixation - statistics & numerical data; Humans; Incentive spirometry; Injury Severity Score; Multidisciplinary care; Pulmonary hygiene; Randomized Controlled Trials as Topic; Respiratory care; Respiratory Insufficiency - diagnostic imaging; Respiratory Insufficiency - epidemiology; Respiratory Insufficiency - etiology; Rib fracture; Rib Fractures - complications; Rib Fractures - physiopathology; Rib Fractures - therapy; Rib plating; Spirometry; Thoracic Injuries - complications; Thoracic Injuries - physiopathology; Thoracic Injuries - therapy; United States - epidemiology
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/j.injury.2019.04.020

Rib fractures are common injuries associated with significant morbidity and mortality, largely due to pulmonary complications. Despite equivocal effectiveness data, incentive spirometers are widely utilized to reduce pulmonary complications in the postoperative setting. Few studies have evaluated the effectiveness of incentive spirometry after rib fracture. Multiple investigations have demonstrated incentive spirometry to be an important screening tool to identify high-risk rib fracture patients who could benefit from aggressive, multidisciplinary pulmonary complication prevention strategies. This review evaluates the epidemiology of rib fractures, their associated pulmonary complications, along with the evidence for optimizing their clinical management through the use of incentive spirometry, multimodal analgesia, and surgical fixation.