Operative Management Versus Conservative Management Of Rib Fractures In The Patients Without Flail Chest

Objective: The purpose of this study was to evaluate the clinical outcome of operative management versus conservative management of rib fractures in the patients without flail chest,in order to make a reference for the clinical work.Methods: A retrospective study was conducted in 90 patients who were diagnosed as having at least one displacement of unilateral rib fracture without flail chest in our hospital during March 2013 to February 2015.These patients were divided into two groups: 46 patients with operative management and 44 patients with conservative management.The comparison was made between the two groups at pain time,time for ambulation,time for recovery,time for oxygen saturation back to normal,complications,chest recovery after2 weeks of injury,fracture healing as well as economical indicators.Results:(1)The treatment effect was not obviously different in the patients who had no more than 2 rib fractures between the two groups in terms of pain time,time for ambulation,time for recovery,time for oxygen saturation back to normal,complications,chest recovery after 2 weeks of injury as well as fracture healing(P>0.05).Patients with at least 3 rib fractures had apparently shorter time for pain,ambulation,recovery and oxygen saturation back to normal in the operative management group.Meanwhile,the patients also have better chest recovery after 2 weeks of injury,better fracture healing and fewer complications(P<0.05).(2)Patients with no more than 2 rib fractures in the operative management group had longer hospital stay and more hospitalization expense(P<0.05).Nevertheless,the hospital stay in the patients undergoing operation who had at least 3 rib fractures did not differ from that in the conservative treatment group.But the hospitalization expense was statistically more costly(P<0.05).Conclusion: This study demonstrates that the number of rib fractures should be identified before making treatment plan for the non-flail rib fracture patients who haveobvious displacement.Operation might be first considered in the patients who have at least3 rib fractures with obvious displacement if the financial condition is allowed.For the patients who have 1 or 2 rib fractures even those with obvious displacement,conservative treatment might also achieve satisfactory outcomes.