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Volume 2024, Issue 7
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

Pain associated with rib fractures can last particularly long. While it is commonly advised in the outpatient setting to anticipate rib fracture pain to improve relatively within a few weeks, there is no evidence to support this statement. The aim of this study was to examine the duration of pain-related disability following single rib fractures based on the objective clinical records.

This study retrospectively reviews the clinical inpatient and outpatient records of 37 patients with single rib fractures treated conservatively at our multi-hospital healthcare system from January to December 2022. The duration of pain-related disability was deduced based on several criteria documented in the patients' clinical records. Univariate and multivariate analyses of risk factors (patient age, sex, injury severity score, smoking status, fractured rib, and side) were performed to find a potential correlation with the time to pain improvement.

In this study, the clinical data of 22 males and 15 females with a single rib fracture and a mean age of 54.4 years (range 18.3–81.5 years) were assessed. According to the available clinical records, the mean duration of pain-related disability was 3.12 weeks (range 4–54 days). Analysis of risk factors showed a significant correlation between duration of pain and increased injury severity scores.

While prolonged chest pain is common with rib fractures, a patient with a single rib fracture may be advised that their chest pain and associated disability would significantly improve within an average of 3–4 weeks. The severity of associated injuries was associated with a longer time to pain improvement.

© 2024 Mahmoud, Blakely, Wertz, Baro, Horwitz, licensee HBKU Press.
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2024-10-19
2024-10-25
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References

  1. Sharma OP, Oswanski MF, Jolly S, Lauer SK, Dressel R, Stombaugh HA. Perils of rib fractures. Am Surg. 2008 Apr;74(4):310–4. doi: 10.1177/000313480807400406.
     [Google Scholar]
  2. Sammy IA, Chatha H, Lecky F, Bouamra O, Fragoso-Iñiguez M, Sattout A, et al. Are first rib fractures a marker for other life-threatening injuries in patients with major trauma? A cohort study of patients on the UK Trauma Audit and Research Network database. Emerg Med J. 2017 Apr;34(4):205–11. doi: 10.1136/emermed-2016-206077.
     [Google Scholar]
  3. Birse F, Williams H, Shipway D, Carlton E. Blunt chest trauma in the elderly: An expert practice review. Emerg Med J. 2020 Feb;37(2):73–8. doi: 10.1136/emermed-2019-209143.
     [Google Scholar]
  4. Van Vledder MG, Kwakernaak V, Hagenaars T, Van Lieshout EMM, Verhofstad MHJ, South West Netherlands Trauma Region Study Group. Patterns of injury and outcomes in the elderly patient with rib fractures: A multicenter observational study. Eur J Trauma Emerg Surg. 2019 Aug;45(4):575–83. doi: 10.1007/s00068-018-0969-9.
     [Google Scholar]
  5. Kerr-Valentic MA, Arthur M, Mullins RJ, Pearson TE, Mayberry JC. Rib fracture pain and disability: Can we do better?. J Trauma. 2003 Jun;54(6):1058–63. doi: 10.1097/01.TA.0000060262.76267.EF.
     [Google Scholar]
  6. Shelat VG, Eileen S, John L, Teo LT, Vijayan A, Chiu MT. Chronic pain and its impact on quality of life following a traumatic rib fracture. Eur J Trauma Emerg Surg. 2012 Aug;38(4):451–5. doi: 10.1007/s00068-012-0186-x.
     [Google Scholar]
  7. Fabricant L, Ham B, Mullins R, Mayberry J. Prolonged pain and disability are common after rib fractures. Am J Surg. 2013 May;205(5):511-516. doi: 10.1016/j.amjsurg.2012.12.007.
     [Google Scholar]
  8. Gordy S, Fabricant L, Ham B, Mullins R, Mayberry J. The contribution of rib fractures to chronic pain and disability. Am J Surg. 2014 May;207(5):659–63. doi: 10.1016/j.amjsurg.2013.12.012.
     [Google Scholar]
  9. Marasco S, Lee G, Summerhayes R, Fitzgerald M, Bailey M. Quality of life after major trauma with multiple rib fractures. Injury. 2015 Jan;46(1):61–5. doi: 10.1016/j.injury.2014.06.014.
     [Google Scholar]
  10. Tulay CM, Yaldiz S, Bilge A. Do we really know the duration of pain after rib fracture?. Kardiochir Torakochirurgia Pol. 2018 Sep;15(3):147–50. doi: 10.5114/kitp.2018.78437.
     [Google Scholar]
  11. Asha SE, Curtis KA, Taylor C, Kwok A. Patient-controlled analgesia compared with interval analgesic dosing for reducing complications in blunt thoracic trauma: A retrospective cohort study. Emerg Med J. 2013 Dec;30(12):1024–8. doi: 10.1136/emermed-2012-201980.
     [Google Scholar]
  12. Williams H, Carlton E. Towards evidence based emergency medicine: Best BETs from the Manchester Royal Infirmary. BET 1: Topical lignocaine patches in traumatic rib fractures. Emerg Med J. 2015 Apr;32(4):333–4. doi: 10.1136/emermed-2015-204681.1.
     [Google Scholar]
  13. Dath R, Nashi M, Sharma Y, Muddu BN. Pneumothorax complicating isolated clavicle fracture. Emerg Med J. 2004 May;21(3):395–6. doi: 10.1136/emj.2002.002733.
     [Google Scholar]
  14. Hoepelman RJ, Beeres FJP, van Veelen N, Houwert RM, Babst R, Link BC, et al. Treatment and outcome in combined scapula and rib fractures: A retrospective study. Eur J Orthop Surg Traumatol. 2023 Aug;33(6):2337–45. doi: 10.1007/s00590-022-03437-2.
     [Google Scholar]
  15. Aamir J, Alade B, Caldwell R, Chapman J, Shah S, Karthikappallil D, et al. Sternal fractures and thoracic injury: An analysis of 288 sternal fractures attending a major trauma centre. Eur J Orthop Surg Traumatol. 2023 Aug;33(6):2619–24. doi: 10.1007/s00590-023-03479-0.
     [Google Scholar]
  16. Puranik G, Gillham N. Bilateral fractured clavicles with multiple rib fractures. Emerg Med J. 2007 Sep;24(9):675. doi: 10.1136/emj.2006.041236.
     [Google Scholar]
  17. Lalandek É, Wylie K. Towards evidence-based emergency medicine: Best BETs from the Manchester Royal Infirmary. BET 1: Ultrasound in the diagnosis of rib fractures. Emerg Med J. 2014 Feb;31(2):169–70. doi: 10.1136/emermed-2013-203506.1.
     [Google Scholar]
  18. Battle C, Hayward S, Eggert S, Evans PA. Comparison of the use of lung ultrasound and chest radiography in the diagnosis of rib fractures: a systematic review. Emerg Med J. 2019 Mar;36(3):185–90. doi: 10.1136/emermed-2017-207416.
     [Google Scholar]
  19. Battle C, Carter K, Newey L, Giamello JD, Melchio R, Hutchings H. Risk factors that predict mortality in patients with blunt chest wall trauma: An updated systematic review and meta-analysis. Emerg Med J. 2023 May;40(5):369–78. doi: 10.1136/emermed-2021-212184.
     [Google Scholar]
  20. Legaye J, Lenfant P, Charlier H. First rib fracture with compression of the distal roots of the brachial plexus. Eur J Orthop Surg Traumatol. 2006 Apr;16:357–9. doi: 10.1007/s00590-006-0097-9.
     [Google Scholar]
  21. Jones NS. An audit of the management of 250 patients with chest trauma in a regional thoracic surgical centre. Arch Emerg Med. 1989 Jun;6(2):97–106. doi: 10.1136/emj.6.2.97.
     [Google Scholar]
  22. Akil A, Ziegeler S, Reichelt J, Semik M, Müller MC, Fischer S. Rib osteosynthesis is a safe and effective treatment and leads to a significant reduction of trauma associated pain. Eur J Trauma Emerg Surg. 2019 Aug;45(4):623–30. doi: 10.1007/s00068-018-01062-5.
     [Google Scholar]
/content/journals/10.5339/jemtac.2024.32
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Single rib fracture. What to expect regarding the duration of pain-related disability? A retrospective observational study and review of literature
Journal of Emergency Medicine, Trauma and Acute Care 2024, 32 (2024); https://doi.org/10.5339/jemtac.2024.32
/content/journals/10.5339/jemtac.2024.32
/content/journals/10.5339/jemtac.2024.32
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  • Article Type: Research Article
Keyword(s): chest, fractures, pain management, ribs and trauma

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