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Physical function and pain after surgical or conservative management of multiple rib fractures - a follow-up study

Artikel i vetenskaplig tidskrift
Författare Monika Fagevik Olsén
Margareta Slobo
L. Klarin
Eva Corina Caragounis
David Pazooki
Hans Granhed
Publicerad i Scandinavian Journal of Trauma Resuscitation & Emergency Medicine
Volym 24
Nummer/häfte 128
ISSN 1757-7241
Publiceringsår 2016
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för kirurgi
Institutionen för neurovetenskap och fysiologi
Institutionen för kliniska vetenskaper, Avdelningen för gastrokirurgisk forskning och utbildning
Språk en
Länkar dx.doi.org/10.1186/s13049-016-0322-...
Ämnesord Flail chest, Range of motion, Rib cage, Ribs, Spirometry, flail chest, operative stabilization, injuries, fixation, women, wall, men, Emergency Medicine
Ämneskategorier Kirurgi

Sammanfattning

Background: There is scarce knowledge of physical function and pain due to multiple rib fractures following trauma. The purpose of this follow-up was to assess respiratory and physical function, pain, range of movement and kinesiophobia in patients with multiple rib fractures who had undergone stabilizing surgery and compare with conservatively managed patients. Methods: A consecutive series of 31 patients with multiple rib fractures who had undergone stabilizing surgery were assessed >1 year after the trauma concerning respiratory and physical function, pain, range of movement in the shoulders and thorax, shoulder function and kinesiophobia. For comparison, 30 patients who were treated conservatively were evaluated with the same outcome measures. Results: The results concerning pain, lung function, shoulder function and level of physical activity were similar in the two groups. The patients who had undergone surgery had a significantly larger range of motion in the thorax (p < 0. 01) and less deterioration in two items in Disability Rating Index (sitting and standing bent over a sink) (p < 0.05). Discussion: It is questionable whether the control group is representative since the majority of patients were invited but refused to participate in the follow-up. In addition, this study is too small to make a definitive conclusion if surgery is better than conservative treatment. But we see some indications, such as a tendency for decreased pain, better thoracic range of motion and physical function which would indicate that surgery is preferable. If operation technique could improve in the future with a less invasive approach, it would presumably decrease post-operative pain and the benefit of surgery would be greater than the morbidity of surgery. Conclusions: Patients undergoing surgery have a similar long-term recovery to those who are treated conservatively except for a better range of motion in the thorax and fewer limitations in physical function. Surgery seems to be beneficial for some patients, the question remains which patients.

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