Abstract：
BACKGROUND: Rib fractures commonly occur in trauma patients with varying presentations. Though the literature in recent years has moved toward favoring more early intervention of acute rib fractures, little has been reported on the matter of surgical fixation for symptomatic rib fracture nonunions.
METHODS: We performed a review of PubMed and Cochrane databases for articles published since 2000. Inclusion criteria were studies with greater than six months of follow-up, while case studies were excluded. A thorough analysis was performed on patient outcomes, complications reported, operative techniques utilized, and fixation systems used, among other parameters reported by the articles.
RESULTS: One hundred and thirty-nine studies resulted from our review, and a total of nine studies met our inclusion criteria with a combined total of 182 patients who underwent open reduction and internal fixation for symptomatic rib fracture nonunions. All studies reported a significant reduction of pain with increased satisfaction in the majority of patients. There were a total of 71 postoperative complications, the most common of which included surgical site infections, hardware failure, and hematoma. The most serious complications were insulting injury to the lung parenchyma or pleura; however, these were extremely rare based off the current literature. The use of bone grafting was common with eight of the nine studies mentioning the benefits of grafting.
CONCLUSIONS: Surgical stabilization of rib fracture nonunions appears to be an appropriate treatment alternative, and various techniques and approaches may be used with similar success. Further studies with higher level of evidence are recommended on the subject.
METHODS: We performed a review of PubMed and Cochrane databases for articles published since 2000. Inclusion criteria were studies with greater than six months of follow-up, while case studies were excluded. A thorough analysis was performed on patient outcomes, complications reported, operative techniques utilized, and fixation systems used, among other parameters reported by the articles.
RESULTS: One hundred and thirty-nine studies resulted from our review, and a total of nine studies met our inclusion criteria with a combined total of 182 patients who underwent open reduction and internal fixation for symptomatic rib fracture nonunions. All studies reported a significant reduction of pain with increased satisfaction in the majority of patients. There were a total of 71 postoperative complications, the most common of which included surgical site infections, hardware failure, and hematoma. The most serious complications were insulting injury to the lung parenchyma or pleura; however, these were extremely rare based off the current literature. The use of bone grafting was common with eight of the nine studies mentioning the benefits of grafting.
CONCLUSIONS: Surgical stabilization of rib fracture nonunions appears to be an appropriate treatment alternative, and various techniques and approaches may be used with similar success. Further studies with higher level of evidence are recommended on the subject.
摘要：
背景：肋骨骨折通常发生在不同表现的创伤患者中。尽管近年来的文献已经倾向于支持急性肋骨骨折的早期干预，关于有症状的肋骨骨折不愈合的手术固定问题的报道很少。
方法：我们对PubMed和Cochrane数据库自2000年以来发表的文章进行了综述。纳入标准是随访超过六个月的研究，而案例研究被排除在外。对患者的预后进行了彻底的分析，报告并发症，使用的操作技术，和使用的固定系统，在文章报告的其他参数中。
结果：我们的综述得出了一百三十九项研究，共有9项研究符合我们的纳入标准,共有182例患者因症状性肋骨骨折不愈合接受切开复位内固定治疗.所有研究都报道了大多数患者的疼痛显着减轻，满意度提高。术后并发症共71例,其中最常见的包括手术部位感染，硬件故障,还有血肿.最严重的并发症是肺实质或胸膜损伤；然而，根据目前的文献，这些都是非常罕见的。骨移植的使用很普遍，九项研究中有八项提到了移植的好处。
结论：肋骨骨折不愈合的手术稳定似乎是一种合适的治疗选择，和各种技术和方法可以使用类似的成功。建议对该主题进行更高水平的证据进一步研究。
方法：我们对PubMed和Cochrane数据库自2000年以来发表的文章进行了综述。纳入标准是随访超过六个月的研究，而案例研究被排除在外。对患者的预后进行了彻底的分析，报告并发症，使用的操作技术，和使用的固定系统，在文章报告的其他参数中。
结果：我们的综述得出了一百三十九项研究，共有9项研究符合我们的纳入标准,共有182例患者因症状性肋骨骨折不愈合接受切开复位内固定治疗.所有研究都报道了大多数患者的疼痛显着减轻，满意度提高。术后并发症共71例,其中最常见的包括手术部位感染，硬件故障,还有血肿.最严重的并发症是肺实质或胸膜损伤；然而，根据目前的文献，这些都是非常罕见的。骨移植的使用很普遍，九项研究中有八项提到了移植的好处。
结论：肋骨骨折不愈合的手术稳定似乎是一种合适的治疗选择，和各种技术和方法可以使用类似的成功。建议对该主题进行更高水平的证据进一步研究。
