The purpose of this research is to compare the outcomes of surgical stabilization and conservative treatment in patients with isolated minor rib fractures.
Isolated minor rib fractures (IMRFs), which is defined by single or two isolated minor rib fractures caused by trauma or stress. Traditionally, rib fractures are managed mainly by surgical stabilization or conservative treatment. In 2018, a systemic review and meta-analysis for patients with multiple rib fractures had revealed a shorter duration of mechanical ventilation, shorter hospital length of stay, and fewer trauma-associated complications in the surgical group than in the non-surgical group. In contrast, IMRFs are seldom life threatening, and compared to extremity fractures, rib fractures do not require matching accurately. Thus, IMRFs are usually treated conservatively. However, the investigators have clinically observed that patients suffering severe pain due to progressive rib displacement may take longer to return to normal activity, have lower quality of life, and even an increased risk of complications. Moreover, limited studies discussed the efficacy of surgical interventions for IMRFs. Therefore, the investigators conduct a prospective observational cohort study to compare the outcomes of surgical stabilization and conservative treatment in patients with IMRFs. The investigators collect patients with IMRFs whose situation were both suitable for surgical and non-surgical interventions. After explanation, patients can decide to undergo conservative or surgical treatment by themselves. The investigators will follow up pain scores, chest X-ray, pulmonary function tests, and duration of return to normal activity. Those data will be statistically analyzed by two-tailed two-sample t-test. This prospective cohort study is supposed to provide more evidence for clinical decision making and optimal management of IMRFs.
Study Type
OBSERVATIONAL
Enrollment
120
Open reduction and internal fixation
Duration of return to normal activity
From day of injury to day of return to normal activity
Time frame: 3 months after operation or after injury
Pain score change at 1 week
Pain Visual analog scales (Pain VAS) to measure pain intensity. A 10 cm horizontal line will be shown and patients mark on the line representing their perception of their current state. The score range from 0 to 10, with following cutpoints: no pain (0 cm), mild pain(1-4 cm), moderate pain (5-7 cm), and severe pain (8-10 cm).
Time frame: Change from injury or operation at 1 week
Pain score change at 3 months
Pain Visual analog scales (Pain VAS) to measure pain intensity. A 10 cm horizontal line will be shown and patients mark on the line representing their perception of their current state. The score range from 0 to 10, with following cutpoints: no pain (0 cm), mild pain(1-4 cm), moderate pain (5-7 cm), and severe pain (8-10 cm).
Time frame: Change from injury or operation at 3 months
Forced vital capacity (FVC) change
Pulmonary function testing with spirometry, using percent of the predicted value (%)
Time frame: Change from injury or operation at 3 months
Forced expiratory volume in the first second (FEV1) change
Pulmonary function testing with spirometry, using percent of the predicted value (%)
Time frame: Change from injury or operation at 3 months
Total lung capacity (TLC) change
Pulmonary function testing with spirometry, using percent of the predicted value (%)
Time frame: Change from injury or operation at 3 months
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Peak expiratory flow (PEF) change
Pulmonary function testing with spirometry, in unit of liters per minute
Time frame: Change from injury or operation at 3 months
36-Item Short Form Survey (SF-36) results
Quality of life will be evaluated via SF-36 questionnaire, and will be scored according to SF-36 scoring rules
Time frame: At 3 months after injury or operation