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Chest Wall Injury Society (CWIS) recommendation for surgical stabilization of non-united rib fractures (SSNURF) to decrease pain, reduce opiate use, and improve patient reported outcomes in patients with rib fracture non-union after trauma.
Chest Wall Injury Society (CWIS) recommendation for surgical stabilization of non-united rib fractures (SSNURF) to decrease pain, reduce opiate use, and improve patient reported outcomes in patients with rib fracture non-union after trauma. The journal of trauma and acute care surgery Forrester, J. D., Bauman, Z. M., Cole, P. A., Edwards, J. G., Knight, A., LaRoque, M., Raffa, T., White, T. W., Kartiko, S. 2023Abstract
Rib fractures are common injuries which can be associated with acute pain and chronic disability. While most rib fractures ultimately go on to achieve bony union, a subset of patients may go on to develop non-union. Management of these non-united rib fractures can be challenging and variability in management exists.The Chest Wall Injury Society's Publication Committee convened to develop recommendations for use of surgical stabilization of non-united rib fractures (SSNURF) to treat traumatic rib fracture non-unions. PubMed, Embase, and the Cochrane database were searched for pertinent studies. Using a process of iterative consensus, all committee members voted to accept or reject the recommendation.No identified studies compared SSNURF to alternative therapy and the overall quality of the body of evidence was rated as low. Risk of bias was identified in all studies. Despite these limitations, there is lower quality evidence suggesting SSNURF may be beneficial for decreasing pain, reducing opiate use, and improving patient reported outcomes among patients with symptomatic rib non-union. However, these benefits should be balanced against risk of symptomatic hardware failure and infection.This guideline document summarizes the current CWIS recommendations regarding use of SSNURF for management of rib non-union.Level IV, therapeutic/care management.
View details for DOI 10.1097/TA.0000000000004083
View details for PubMedID 37728432