North Pacific Surgical AssociationProlonged pain and disability are common after rib fractures
Section snippets
Methods
All injured patients evaluated in the Oregon Health & Science University (OHSU) emergency department or inpatient units from July 2005 to January 2008 were screened for rib fractures. Patients with rib fractures confirmed by radiologist interpretation of plain films or computed tomographic scan were contacted for enrollment within 14 days of injury. Exclusion criteria included patients 15 years or younger, non–English-speaking patients, patients determined by the investigators as being unlikely
Results
One hundred forty-five male patients and 58 female patients with a mean ISS of 20 (range, 1 to 59) had a mean of 5.4 rib fractures (range, 1 to 29). Forty-four (22%) patients had bilateral fractures, 15 (7%) had flail chest, and 92 (45%) had 1 or more associated injuries with an OIS of 2 or more. The region of the chest wall with the most rib fractures was posterior in 50%, lateral in 26%, and anterior in 24% of patients.
Race and ethnicity included white non-Hispanic (191 patients [94%]),
Comments
Although rib fractures are notoriously painful, the natural history of rib fracture pain and disability has not been well studied.6 The expectations that most rib fracture pain resolves by 8 weeks and that rib fractures contribute little to long-term disability have never been subjected to prospective scrutiny. These unvalidated expectations have been an obstacle to the development of treatments that might be expected to improve the outcome of patients with rib fractures. With this prospective
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Supported by a grant from the Medical Research Foundation of Oregon.
John C. Mayberry, M.D. has disclosed consultant fees and honoraria of less than $10,000 over the past 5 years from Acute Innovations, LLC.