Rib Fracture Non Union

Slater MS, Mayberry JC, Trunkey DD. Operative stabilization of a flail chest six years after injury. Ann Thorac Surg 2001;72(2):600-1.

ABSTRACT: We report a case of operative stabilization of an incompetent upper chest wall 6 years following flail chest. The indications for stabilization were chronic pain and dyspnea associated with rib malunion and loss of hemithorax volume. At operation, multiple pseudoarthroses were encountered and partial resection of ribs three and four was required. Malleable plates were used to bridge the gaps created by the resection and were secured in place with sternal wire. The patient reported a dramatic relief of symptoms and, at 18 months postoperatively, continues to work full-time on his cattle ranch essentially pain-free.

Beal SL, Oreskovich MR. Long-term disability associated with flail chest injury. Am J Surg 1985;150(3):324-6.

ABSTRACT: Twenty-two trauma victims who had sustained flail chest as their only significant injury were evaluated to determine the final outcome. Fourteen patients (63.9 percent) were found to have long-term sequelae. The most common long-term problems after flail chest injury were persistent chest wall pain, chest wall deformity, and dyspnea on exertion. Five patients (22 percent) remained disabled in varying degrees.

Cacchione RN, Richardson JD, Seligson D. Painful nonunion of multiple rib fractures managed by operative stabilization. J Trauma 2000;48(2):319-21.

  • Complex or severe chest wall injuries often require intensive care for pain management, ventilatory support, or because of associated lung or cardiac injury.
  • When fixation is required, the use of small titanium plates provides a good method of stabilizing the fractures to allow for stable healing.
  • Even though fixation is rarely required, there are occasional patients in which this procedure is beneficial.