Outcomes After Operative Management of Symptomatic Rib Nonunion. Issue 6 (June 2015)

• Record Type: Journal Article
• Authors: Gauger, Erich M.; Hill, Brian W.; Lafferty, Paul M.; Cole, Peter A.
• Is Part Of: Journal of orthopaedic trauma. Volume 29:Issue 6(2015)
• Publication Date: 2015-06
• Subjects: Orthopedics -- Periodicals; Wounds and injuries -- Periodicals; Orthopedics -- Periodicals; Wounds and Injuries -- therapy -- Periodicals; Periodicals; 617.47044
• DOI: 10.1097/BOT.0000000000000254
• Languages: English
• ISSNs: 0890-5339

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Objective:</title> <p>To report the outcomes of rib reconstruction after painful nonunion.</p> </sec> <sec> <title>Design:</title> <p>Retrospective case series.</p> </sec> <sec> <title>Setting:</title> <p>Level I trauma center.</p> </sec> <sec> <title>Patients/Participants:</title> <p>Between November 2007 and May 2013, 10 patients who presented with 16 rib nonunions and disabling pain were treated with reconstruction of their nonunited rib fractures.</p> </sec> <sec> <title>Intervention:</title> <p>Rib nonunion reconstruction predominately with iliac crest bone graft and a tension band plate with a locked precontoured plating system for ribs.</p> </sec> <sec> <title>Main Outcome Measurements:</title> <p>Demographic data, mechanism of injury, and number of rib nonunions were recorded. Operative procedure, length of follow-up, complications, Short Form Survey 36, and a patient questionnaire were also captured and documented.</p> </sec> <sec> <title>Results:</title> <p>Eight of the 10 patients sustained their original fractures from a fall. Outcomes were available for the 10 patients at a mean follow-up of up of 18.6 months (range, 3–46 months). All 16 ribs went on to union with a mean time from reconstruction to union of 14.7 weeks (range, 12–24 weeks). At final follow-up, the mean mental and physical component Short Form Survey 36 scores were 54.4 and 43.5, respectively. Eight of the 10 patients were able to return to work and/or previous activities without limitations. Complications included 1 wound infection that resolved after irrigation and debridement with adjunctive antibiotics. One symptomatic implant was removed.</p> </sec> <sec> <title>Conclusions:</title> <p>Ten patients with 16 symptomatic rib nonunions were reconstructed using autologous bone graft and implant/mesh fixation manifesting in successful union with improved patient function and a low rate of complications.</p> </sec> <sec> <title>Level of Evidence:</title> <p>Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.</p> </sec> </abstract>