Clinical management of rib fractures and methods for prevention of pulmonary complications: A review

Injury. 2019 Jun;50(6):1159-1165. doi: 10.1016/j.injury.2019.04.020. Epub 2019 Apr 22.

Abstract

Rib fractures are common injuries associated with significant morbidity and mortality, largely due to pulmonary complications. Despite equivocal effectiveness data, incentive spirometers are widely utilized to reduce pulmonary complications in the postoperative setting. Few studies have evaluated the effectiveness of incentive spirometry after rib fracture. Multiple investigations have demonstrated incentive spirometry to be an important screening tool to identify high-risk rib fracture patients who could benefit from aggressive, multidisciplinary pulmonary complication prevention strategies. This review evaluates the epidemiology of rib fractures, their associated pulmonary complications, along with the evidence for optimizing their clinical management through the use of incentive spirometry, multimodal analgesia, and surgical fixation.

Keywords: Chest trauma; IS; Incentive spirometry; Multidisciplinary care; Pulmonary hygiene; Respiratory care; Rib fracture; Rib plating.

Publication types

  • Review

MeSH terms

  • Fracture Fixation / statistics & numerical data*
  • Humans
  • Injury Severity Score
  • Randomized Controlled Trials as Topic
  • Respiratory Insufficiency / diagnostic imaging*
  • Respiratory Insufficiency / epidemiology
  • Respiratory Insufficiency / etiology
  • Rib Fractures / complications*
  • Rib Fractures / physiopathology
  • Rib Fractures / therapy
  • Spirometry
  • Thoracic Injuries / complications*
  • Thoracic Injuries / physiopathology
  • Thoracic Injuries / therapy
  • United States / epidemiology