Analysis of rib fractures in secondary emergency hospital

Abstract

We retrospectively analyzed 90 patients admitted with rib fractures between 2015 and 2019 to Japanese Red Cross Fukui Hospital, which is a secondary emergency hospital. The median age was 72.5 (16-96) years, the median number of rib fractures was four (1-10), median length of hospital stay was nine (2-60) days, and discharge states of patients were 68 (75.6%) returning to their home or nursing home, and 22 (24.4%) transferring to a rehabilitation hospital. Seventy-five (83.3%) patients had combined injury, of whom 68 (75.6%) and 18 (20%) patients including duplications suffered from chest and non-chest injuries, respectively. We performed tube thoracostomy in 35 (38.9%) for hemopneumothorax; the median length of drainage was three (1-13) days, and the median time from injury to drainage was two (0-17) days. We performed two emergency operations for massive hemothorax, and five operations: two for flail chest, and three for rib displacement with sharp fragments entering the thoracic cavity. Pneumonia occurred in four patients (4.4%), of whom two needed mechanical ventilation. Rib fracture is a common trauma in daily practice. The management of rib fractures is comprehensive. Although conservative treatment is the main treatment for rib fractures, surgical stabilization may be optimal. It is important to evaluate combined injury, pay careful attention to the probability of late-onset-hemopneumothorax or pneumonia, and cooperate with health care workers involved in respiratory care and discharge support from the beginning of hospitalization.