Efficacy Evaluation Of Open Reduction Internal Fixation And Conservative Treatment In The Treatment Of Multiple Rib Fractures

Objective:The objective of this study was to compare the efficacy of open reduction and internal fixation with conservative treatment in the treatment of multiple rib fractures.Methods: A total of 355 patients diagnosed with multiple rib fracture admitted to the thoracic surgery department of a hospital from January 2015 to August 2022 were retrospectively analyzed.According to the inclusion and exclusion criteria,87 patients meeting the study conditions were screened,including 40 patients in the operation group and 47 patients in the conservative treatment group.The operation group was divided into group A(surgical treatment within 48 h after injury)and group B(surgical treatment after 48 h injury)according to the treatment time of patients.By analyzing and comparing the basic information of patients in the operation group and the conservative group,as well as group A and group B,such as gender,age,BMI,cause of injury and number of rib fractures,etc.Total length of stay,total hospitalization cost,duration of pain,incidence of complications during hospitalization(pulmonary infection and atatasis),arterial blood gas status(on admission,1 day after treatment,4 days after treatment),rib healing status and other clinical indicators were statistically analyzed and compared for multiple rib fractures treated by open reduction and internal fixation surgery and conservative treatment.To provide the basis for the selection of clinical treatment..Results:By comparing open reduction and internal fixation treatment with conservative treatment for multiple rib fractures,the mean length of hospital stay in the surgical treatment group was shorter than that in the conservative treatment group(13.8±4.49,15.7±3.81,P<0.05),the average hospitalization cost was higher than that of conservative treatment group(51378± 17432,14401 ±6144),the length of stay and hospitalization cost were statistically different between the two groups(P<0.05).There was no significant difference in pulmonary infection between the operation group and the conservative treatment group during hospitalization(P>0.05),but there was significant difference in atelectasis between the operation group and the conservative treatment group(P<0.05).The duration of pain in hospital was shorter in the surgery group than in the conservative group,and the difference was statistically significant(P<0.05).The results of arterial blood gas analysis were different between the operation group and the conservative group(P<0.05),the effect of surgical treatment group was better than conservative treatment group;The results of follow-up review 3 months after discharge showed that the healing effect of the surgical treatment group was better than that of the conservative treatment group,and the results were statistically different(P<0.05).The average length of hospitalization in group A was shorter than that in group B(11.90±2.63,13.95±3.53),the difference between the two groups was statistically significant(P<0.05),and the average hospitalization cost was less than that in group B(52222± 16107,55034 ±18745),but the difference was not statistically significant(P>0.05).There was no statistical significance in pulmonary infection and atelectasis between group A and group B(P>0.05).The duration of pain in group A was shorter than that in group B,but the difference was not statistically significant(P>0.05).There were differences in arterial blood gas results between group A and group B during hospitalization,but the difference was not statistically significant(P>0.05).There was no significant difference in fracture healing between group A and group B(P>0.05).Conclusions: Patients with multiple rib fractures treated with open reduction and internal fixation may have higher hospital costs but better clinical outcomes than those treated conservatively.Patients receiving surgical treatment have low incidence of atelectasis,obvious improvement in lung function,short duration of pain and low rate of fracture malunion,and can shorten the length of hospital stay,greatly improve the quality of life and prognosis of patients,so that patients can get better clinical benefits.Different surgical timing also has certain differences in the quality of life of patients.Compared with late surgery,early surgical treatment can shorten the length of hospital stay of patients to a certain extent,reduce hospitalization costs and reduce complications during hospitalization,providing certain basis for clinical treatment.